Abstract

A 63-year-old man was seen at the department of internal medicine in our hospital because of dysphagia. Endoscopic examination of the upper gastrointestinal tract revealed an esophageal cancer of the lower intrathoracic esophagus, but further exploration with endoscopy was impossible because a stricture at the site of cancer was too narrow to pass through the endoscopy. Upper gastrointestinal series performed on another day revealed two elevated lesions in the stomach. The patient was referred to the department for operation. Intra-thoracic esophagectomy, total gastrectomy, and reconstruction with the small intestine were performed. Pathologically the resected specimens were diagnosed as squamous cell carcinoma of the esophagus, and moderately differentiated tubular adenocarcinoma and poorly differentiated adenocarcinoma of the stomach. Esophageal cancers with gastric cancer have been reported to represent 0.3-2.5% of all esophageal cancers, but synchronous double cancer of esophagus and stomach is rare. For the exploration of gastrointestinal malignant tumor, careful attitude entertaining probable double cancer is of importance. And appropriate selection of operative procedure that can provide a cure with minimal surgical stress may be critical to treat such synchronous double cancer of the esophagus and stomach.

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