A Case of Esophageal Carcinoma with Giant Intramural Gastric Metastasis.

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A 45-year-old man was admitted to the hospital because of a 6-month history of dysphagia. Radiologic and endscopic examination revealed an esophageal carcinoma with a giant gastric tumor. A distal esophagectomy and a total gastrectomy with an esophagojejunal anastmosis were performed. Histological examination of resected specimen showed that a IIc+IIb-like lesion of the lower portion of the esophagus was well differentiated squamous cell carcinoma (m2), 4.5×4.0cm in size, with marked lymphatic invasion and intramural metastatic foci (6.5×6.0×3.8cm) at the cardial portion. He was discharge from the hospital and has been recurrence free for 8 years 9 months after the surgery. Esophageal carcinoma with intramural gastric metastasis is relatively rare in a frequency of 1.0_??_4.7% of all esophageal carcinomas. It is often observed that some metastases are larger than primary esophageal tumors, and others show a rapid growth. Patients who have esophageal carcinoma should receive careful examination of the stomach, even though the esophageal carcinoma is in an early stage.
日本臨床外科学会の論文