A case of gastric cancer with intramural metastasis to the esophagus

A case of gastric carcinoma with intramural metastasis to the esophagus is reported. A 50-year-old male patient had gastric upset, nausea, and high frequency of vomiting since September 1993. He was diagnosed to our department by a doctor in his neighborhood in December of the same year. The endoscopic examination demonstrated a tumor of Borrmann type 2 on the lesser curvature of the angle to the antrum in the stomach and a small elevation (approximately 2 cm in diameter) in the esophagus of the lower chest. The esophageal lesion was negative for Lugol solution staining. Although these lesions were separated from each other, histologically both were differentiated adenocarcinoma. Palliative distal gastrectomy and Billroth II were performed as of peritoneal dissemination was demonstrated by perioperative cytology. The oral wedge of the stomach was free from cancer cells in histologically. Complete response was obtained for metastasis by adjuvant chemotherapy (CDDP+UFT). However, he died from brain metastasis 7 months after the operation. The gastric cancer with intramural metastasis to the esophagus is very rare, and only 10 cases including our experience have been reported so far. Sine prognosis is very bad, adjuvant chemotherapy with palliative operation should be considered in these patients.