Abstract
A 60-year-old male was admitted with a 2-month history of dysphagia. Roentogenological and endoscopic examination revealed an esophageal carcinoma with a giant intramural gastric metastasis. The intramural gastric metastasis took the form of a giant 8.0×7.5×7.0cm submucosal tumor that invaded the diaphragm and left lobe of the liver. Distal esophagectomy and total gastrectomy via left thoracotomy and laparotomy were performed via continguous incisions, and esophagojejunostomy was performed through an anterior thoracic route after blunt resection of the proximal esophagus. Postoperatively, the patient was treated with 45 Gy of radiation to neck bilaterally, and mediastinum, in a “T”-shaped pattern. At 25 months after operation, he is well with no evidence of recurrence. It is rare for a metastatic lesion of esophageal cancer to the stomach to be markedly larger than the primary lesion, as in the present case. We also discuss 14 cases of esophageal carcinoma with intramural gastric metastasis encountered at the National Defense Medical College Hospital.
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