Abstract
A 70-year-old man complaining of dysphagia was diagnosed as having advanced adenocarcinoma of the esophagogastric junction with lower esophageal intramural metastases by upper gastrointestinal endoscopy. After four courses of chemotherapy with S-1 and docetaxel, the primary tumor markedly decreased in size and the lesions of intramural metastases disappeared. Thoracoscopic subtotal esophagectomy and reconstruction with a gastric tube through the posterior mediastinal route were performed. Pathological examination showed most of cancer cells at the primary lesion to have severely degenerated or become necrotic, with a part where adenocarcinoma tissue remnant was seen. No viable cancer cells were evident at the site of intramural metastases. The patient received the postoperative chemotherapy with S-1 for one year, and shows no signs of recurrence as of five years after the surgery.
We successfully treated a case of adenocarcinoma of the esophagogastric junction with esophageal intramural metastases, of which prognosis is believed to be poor, by preoperative S-1/docetaxel therapy followed by radical operation.
