Abstract
Metastatic carcinoma of the alimental canal, except for direct invasion, is uncommon. We have experienced a case of gastro-esophageal metastatic carcinoma diagnosed by radiological and endoscopical studies of the upper GI tract. A 59 year-old female was admitted to our hospital with complaints of nausea and emaciation. The upper GI series disclosed several protruded lesions with central depression mimicking verrucous gastritis at the gastric antrum. The panendoscopy revealed a flat elevated lesion with central ulceration on the mid esophagus and revealed several similar lesions on the stomach. Biopsy study was performed from each lesions, and disclosed signet ring cell carcinoma. A diagnosis of metastatic carcinoma to the esophagus and stomach was made. Further investigation was not allowed because the patient's physical status was progressively worsened and died on the 15th hospital day. On necropsy study, a definite tumor was found at the neck of the gall bladder and this tumor was considered to be the primary site, because there were no detectable tumors present in the other organs. Histology of the tumor was signet ring cell carcinoma. At the nodular lesions of the esophagus and stomach, signet ring cell carcinomas were distributed in the submucosal layer and were partly invaded to the mucosa. With routine usage of radiology and endoscopy, the detection of gastro-esophageal lesions is easy. However, the differentaial diagnosis from metastatic carcinoma in the esophagus and stomach to protruded early cancer, submucosal tumor and verrucous gastritis etc. is difficult without biopsy study.
