Department of Gastroenterology, The First Hospital of China Medical University, Shenyang 110000, Liaoning Province, China.
Department of Endoscopy, The First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning Province, China.
World J Gastroenterol. 2023 Nov 28;29(44):5935-5944. doi: 10.3748/wjg.v29.i44.5935.
Esophageal carcinoma is a highly aggressive digestive cancer responsible for a notable proportion of cancer-related deaths worldwide. Its elevated metastatic rate contributes to a poor prognosis in affected patients. In this case review, we aim to summarize the metastatic characteristics of intramural gastric metastasis (IGM) in mucosal esophageal squamous carcinoma.
A 56-year-old man was admitted to our hospital because of a dry cough with an esophageal sensation for one year. Endoscopic examination revealed a 2.0 cm 1.0 cm, superficial esophageal squamous cell carcinoma, and the patient underwent endoscopic submucosal dissection (ESD). Fifteen months after ESD, positron emission tomography/computed tomography revealed that the metabolism of the stomach cardia wall had increased slightly. However, the mucosa of the gastric cardia was smooth under gastroendoscopy. Two years after ESD, endoscopic examination revealed a giant gastric cardia carcinoma, while the esophageal mucosa was smooth, and no advanced cancer was found. A biopsy of the gastric cardia indicated squamous-cell carcinoma. The patient received immunochemotherapy and radiotherapy for esophageal cancer for 8 mo and is currently under follow-up.
Early-stage esophageal carcinoma with IGM is rare. Despite the ESD of the primary lesion, IGM may still occur and should be closely monitored after ESD.
食管癌是一种高度侵袭性的消化道癌症,在全球范围内导致了相当比例的癌症相关死亡。其较高的转移率导致了受影响患者的预后不良。在本病例回顾中,我们旨在总结黏膜食管鳞癌合并壁内胃转移(IGM)的转移特征。
一名 56 岁男性因干咳伴食管感 1 年而入院。内镜检查显示 2.0cm×1.0cm 的表浅食管鳞癌,患者接受了内镜黏膜下剥离术(ESD)。ESD 后 15 个月,正电子发射断层扫描/计算机断层扫描显示胃贲门壁的代谢略有增加。然而,胃镜下贲门黏膜光滑。ESD 后 2 年,内镜检查显示巨大贲门癌,而食管黏膜光滑,未发现晚期癌症。贲门活检提示鳞状细胞癌。患者接受了 8 个月的食管癌免疫化疗和放疗,目前正在随访中。
早期食管癌合并 IGM 较为罕见。尽管对原发病灶进行了 ESD,但 IGM 仍可能发生,ESD 后应密切监测。