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A case of mucosal esophageal carcinoma with large intramural metastasis in the stomach



A case of mucosal esophageal carcinoma with large intramural metastasis in the stomach



Journal of the Japanese Association for Thoracic Surgery 37(7): 1430-1435



The prognosis of mucosal carcinoma of the esophagus is extremely good because of low frequency of lymphatic invasion compared with submucosal carcinoma. a 64-year-old male was admitted presented with dysphagia and weight loss. Roentgenogram and esophagoscopy revealed erosive lesions in the lower portion of the esophagus and a huge submucosal tumor that looked like the myosarcoma in the cardial portion. After total resection of thoracic esophagus and partilal gastrectomy, esophagogastrostomy was done through the anterior thoracic route. During the operation, we found a few disseminative foci in the thoracic cavity (p11) and direct invasion of cardial tumor to the celiac portion. Therefore, the operation was absolute by palliative. Histological examination of the resected specimen showed that the IIc-like lesion of the lower portion of the esophagus was a moderately differentiated squamous cell carcinoma invasing the mucosa (mm), which was 2.0 .times. 1.6 cm in size, with marked lymphatic invasion, and intra-mural metastatic foci (7.0 .times. 5.0 cm) at the cardial portion. The patient died 3 months after the operation with mediastinal lymph hodes metastasis. In our 19 cases of resected mucosal carcinoma of the esophagus, lymphatic invasion was positive in 16%, and lymph hodes metastasis was positive in 16%, and intramuralmetastasis was in only one case. Frequency of intramural metastasis in esophageal carcinoma is about 10% in sm -a3 lesion, 5% in mm. In our experience, the prognosis of curatively resected muscosal carcinoma of the esophagus is generally good. We get long survivals, when curative operation is undergone, even if the lymphatic invasion is positive.

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Accession: 006932861

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PMID: 2794606


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