title: [A case of esophageal squamous cell carcinoma with submucosal tumor-like tumor due to direct invasion of the gastric wall].
abstract: We encountered a case of esophageal squamous cell carcinoma (ESCC) with submucosal tumor (SMT)-like tumor in the cardia of the stomach, formed by direct invasion of the gastric wall. The patient was a 72-year-old woman with dysphagia. Upper endoscopy showed a giant SMT-like tumor in the cardia of the stomach, and imaging studies revealed metastasis to the nearby and distant lymph nodes. Although squamous cell carcinoma was diagnosed by biopsy of the SMT-like tumor in the gastric cardia, gastric involvement was suspected via metastasis to the perigastric lymph nodes or direct invasion of the gastric wall by the ESCC, because the primary lesion of ESCC could not be identified during the examinations. FP chemotherapy (days 1-5, 800 mg/m2 5-fluorouracil[5-FU]; day 1, 80 mg/m2 cisplatin[CDDP]) was initiated for the treatment of ESCC. Considering the risk of invasion, we discontinued the chemotherapy and performed lower esophagectomy and cardiectomy. Pathologically, the primary lesion of the ESCC was detected in the abdominal esophagus, and the SMT-like tumor in the gastric cardia was determined to result from direct invasion of the gastric wall by the ESCC. We herein report a rare case of ESCC with an SMT-like tumor in the gastric cardia formed by direct invasion of the gastric wall.
authors.affiliation: Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Nako
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.forename: Ryo
authors.initials: R
authors.lastname: Morimura
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Chouhei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D017809:Fatal Outcome; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D009361:Neoplasm Invasiveness
chemical_list: D002945:Cisplatin; D005472:Fluorouracil