Abstract
We report a case of early synchronous double cancer of the esophagus and stomach. A 63-year-old male was admitted to our hospital because of an abnormal finding of the stomach detected on his medical examination. Barium meal study revealed a slightly elevated lesion which size was 23×8 mm at the anterior wall of the lower esophagus but no findings of the stomach. By endoscopic examination, this elevated lesion was surrounded by reddish and irregular mucosa, which was not stained by Lugol application. Endoscopic examination of the stomach showed a depressed lesion (3×3 mm in diameter) at the anterior wall of the gastric angle but there was no abnormality at the area where an abnormal finding was suspected by X-ray examination. Biopsied specimens of the esophageal lesion showed squamous cell carcinoma and those of the stomach were tubular adenocarcinoma. A total resection of the thoracic esophagus and stomach was performed and reconstruction was done by colon transplant through the retrosternal rout. Pathological examination revealed protruded type esophageal carcinoma associated with superficial flat type (I+IIb, 75×40 mm in diameter) limited to the submucosal layer and superficial depressed type mucosal carcinoma of the stomach (IIc, 4×4 mm in diameter). Only 17 cases of early synchronous double cancer of the esophagus and stomach have been reported in Japanese literatures. This case is the first one in which gastric lesion was a microcancer and this minute lesion was successfully diagnosed before the operation.
