Esophageal carcinoma metastatic to the stomach. A clinicopathologic study of 35 cases.

Esophageal carcinoma metastatic to the stomach was analyzed in 35 patients. Ten were discovered in surgical specimens and 25 at autopsy. All patients were men with a mean age of 62 years. Primary lesions were most frequently located in the middle of thoracic esophagus and were larger than 7 cm. Undifferentiated carcinoma was found in 29% of the patients. Local spread of the primary lesions to neighboring structures was seen in 34%. Lymphatic invasion, and intramural metastases within the esophagus, as well as lymph node metastases, were predominant. Metastatic lesions within the stomach were mostly located in the gastric cardia, were less than 2 cm or more than 4 cm in size, and resembled submucosal tumors. Gastric metastases occasionally spread from the submucosa to neighboring structures. In spite of aggressive treatment, the prognosis was extremely poor because of multiple spread of carcinoma to local regions, lymph nodes, and distant organs. The clinicopathologic characteristics of this disease and possible treatment are discussed.