Abstract
The patient was a 75-year-old woman. An endoscopic submucosal dissection was done for esophageal carcinoma in May 2005. On pathology, a moderately differentiated squamous cell carcinoma with vascular invasion was found. Adjuvant chemoradiation therapy was given to prevent regional recurrence. No signs of recurrence were observed for two years and seven months. An ulcerative lesion was detected at the stomach cardia on upper gastrointestinal endoscopy done in December 2007 ; the biopsy results confirmed the presence of squamous cell carcinoma. Other imaging studies did not reveal any other metastatic lesions. A proximal gastrectomy was done under the diagnosis of recurrent esophageal carcinoma in the gastric wall. Postoperative pathology showed squamous cell carcinoma which was analogous to the primary lesion. The tumor was mainly located in the submucosal layer, and vessel invasion was also observed. We suspected that the gastric lesion was a heterochronic metastasis of the esophageal carcinoma originating from an intramural metastasis to the gastric wall. Reports of such heterochronic metastasis of esophageal carcinoma are rare ; thus, we report this case along with a discussion.
