A CASE OF EARLY ESOPHAGEAL CANCER ASSOCIATED WITH SIMULTANEOUS EARLY GASTRIC CANCER

Abstract

A 68 year-old man with a several year history of gastric ulcer consulted this clinic for a detailed evaluation on July 15, 1986. Initial gastric fluoroscopy revealed an early gastric cancer, type IIc on the posterior wall of the lower corpus. Screening esophageal fluoroscopy as well as detailed examinations failed to reveal any abnormality. Panendoscopy was then performed, and an erythematous, slightly ulcerated lesion was discovered in the direction of 3 o'clock at a distance of 32 cm from the incisor line. Lugol's solution was used to stain this area and revealed a definite non-staining area around the lesion. Endoscopic biopsy of the central portion of the lesion revealed a squamous cell carcinoma. On October 8, 1986, radical surgical therapy was performed consisting of a resection of the thoracic esophagus, total gastrectomy and hemicolonoplasty at the Kosei Hospital. The gastric lesion grossly consisted of a IIc type early gastric cancer accompanied by a ul-II scar. Histologic examination revealed a highly differentiated adenocarcinoma localized within the mucosa. In the esophageal specimen, a superficial mm-type cancer was noted in the Ei portion. Histological examination revealed a highly differentiated squamous epithelial carcinoma. In the tissue around the lesion, multiple isolated foci of carcinoma within the epithelial layer were noted.