We report herein a case of hemophagocytic syndrome after surgery for early thoracic esophageal cancer.
A 42-year-old woman, who underwent a subtotal esophagectomy and lymphadenectomy with retrosternal esophagogasrostomy for early thoracic esophageal cancer, revealed leukopenia (1.1×10³/μl) on the operative day and administration of G-CSF was started. General condition was stable and blood leukocyte count recovered gradually, but she suddenly went into shock with severe pancytopenia on the postoperative day (POD) 9. Opportunistic infection on the left lateral abdominal wall was revealed by CT scan on the POD 10, and bone marrow aspiration taken on the POD 11 showed macrophages which phagocytosed not only leukocytes, but also erythrocytes and platelets. Therefore, she was diagnosed as having hemophagocytic syndrome. Steroid pulse therapy was initiated, but she died of disseminated intravascular coagulation and multiple organ failure on the POD 24. Although surgery rarely provokes hemophagocytic syndrome, the disease must be added to a possible postoperative complication.