title: Multiple and metachronous esophageal intramural metastases from a gastric adenocarcinoma.
abstract: Esophageal squamous cell carcinoma is often accompanied by intramural metastases, and it has been reported to carry a poor prognosis. Intramural metastasis from gastric cancer to the esophageal wall, however, has rarely been reported. We herein report a rare case of a 46-year-old man with an elevated esophageal lesion, resembling a 0-IIa-type esophageal cancer, which was discovered 13 months after a total gastrectomy performed for gastric cancer. The esophageal tumor, resected by endoscopic mucosal resection (EMR), was an adenocarcinoma with the same histology as the previously resected primary gastric cancer, and it showed massive lymphatic permeation. Soon after the EMR, other similar lesions emerged on the esophageal wall. We therefore considered the esophageal tumor to be a systemic expansion of the primary gastric cancer, and we administered the anticancer drug, S-1. Esophageal intramural metastases from a gastric cancer imply a systemic expansion of the gastric cancer, and portend a poor prognosis.
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toh
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Aoki
authors.forename: Norifumi
authors.initials: N
authors.lastname: Harimoto
authors.forename: Jyunya
authors.initials: J
authors.lastname: Taomoto
authors.forename: Takaaki
authors.initials: T
authors.lastname: Masuda
authors.forename: Takefumi
authors.initials: T
authors.lastname: Ohga
authors.forename: Eisuke
authors.initials: E
authors.lastname: Adachi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamura
authors.forename: Minako
authors.initials: M
authors.lastname: Hirahashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000556:secondary* / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery