Metachronous Gastric Tube Cancer After Esophagectomy with Gastric Pull-Up – Case Report

Susan Müller,D Igna,Cristina Jorge,S Gafarli,M Glanemann

doi:10.31487/j.scr.2020.02.07

Abstract

The progresses in the therapy and methods of diagnosis of malignancies led to a prolonged survival and, consequently, to an increase in secondary tumors in cancer survivor patients [1-7]. We report the case of a 64-year-old patient who was diagnosed with a second primary adenocarcinoma in the gastric conduit, more than two years after the esophagectomy with gastric pull-up. We performed a resection of the gastric conduit and reconstructed with an ileocolon interposition.

Highlights

The stomach remains the most accepted method of reconstruction of the alimentary tract following an esophagectomy in cancer patients [4, 811]
We report the case of a 64-year-old patient who was diagnosed with a second primary adenocarcinoma in the gastric conduit, more than two years after the esophagectomy with gastric pull-up
The staging CT demonstrated a circular swelling of the mucosa of the esophagogastric anastomosis (Figure 2) without regional or distant metastases but could not detect any lesion in the gastric antrum

Summary

Introduction

The stomach remains the most accepted method of reconstruction of the alimentary tract following an esophagectomy in cancer patients [4, 811]. The number of reported cases of metachronous gastric tube cancers (hereinafter GTC) has increased in the last years due to improved therapy and screening [2]. These advances led to a better prognosis and survival rate, raising the incidence of secondary malignancies [1,2,3,4,5,6,7, 12]. The staging CT demonstrated a circular swelling of the mucosa of the esophagogastric anastomosis (Figure 2) (histopathologically corresponding to a reflux esophagitis) without regional or distant metastases but could not detect any lesion in the gastric antrum. Bearing in mind that our patient did not have any major comorbidities and the tumor was locally advanced without metastases, a primary resection with colon interposition was the therapy of choice

Surgery

Postoperative Course

Findings

Discussion

Conclusion