J.Jpn. Surg. Soc.. 91(10): 1567-1573, 1990

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Original article

EXPERIMENTAL AND LCINICAL STUDY FOR SPREAD OF CARDIAC CANER TO THE DIAPHRAGM

We investigated the route of lymphogenous metastasis of cardiac cancer to the diaphragm, making a model of cardiac cancer using VX₂ tumor of rabbit. Metastasis ratio of each lymph node in the experimental model indicated a correlation with clinical cases. Histological investigation of the diaphragm indicated floating of VX₂ cancer cells in the lymphvessels in the diaphragm in 4 of 20 cases (20%).
After, injection of CH₄₄ at the oralside of the tumor, the presence of CH₄₄ in the lymphvessels in the diaphragm were seen in 6 of 16 cases (37.5%).
Clinically, the left diaphragm was excised as wide as possible in 22 cases of cardiac cancer with esophageal invasion by left thoraco abdominal approach. Histologically, embolic of the tumor or floating tumor cells in the lymphvessels in the diaphragm were seen in 6 of 22 cases (27.3%).
These results revealed that carcinoma proliferating in the cardia can apparently spread to the diaphragm more extensively than has been previous believed.

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