Ikeda Osamu, Toh Yasushi, Aoki Yoshiro, Harimoto Norifumi, Taomoto Jyunya, Masuda Takaaki, Ohga Takefumi, Adachi Eisuke, Sakaguchi Yoshihisa, Okamura Takeshi, Hirahashi Minako, Nishiyama Kenichi, Baba Hideo
Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Gastric Cancer. 2008;11(2):119-22. doi: 10.1007/s10120-007-0449-0. Epub 2008 Jul 2.
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.
食管鳞状细胞癌常伴有壁内转移，据报道其预后较差。然而，胃癌向食管壁的壁内转移鲜有报道。在此，我们报告一例罕见病例，一名46岁男性，食管病变隆起，类似0-IIa型食管癌，在因胃癌行全胃切除术后13个月被发现。通过内镜黏膜切除术（EMR）切除的食管肿瘤为腺癌，组织学与先前切除的原发性胃癌相同，并显示有大量淋巴管浸润。EMR术后不久，食管壁上出现了其他类似病变。因此，我们认为食管肿瘤是原发性胃癌的全身扩散，并给予了抗癌药物S-1。胃癌的食管壁内转移意味着胃癌的全身扩散，预后不良。
