Abstract
We experienced a case of synchronous double cancer, an undifferentiated esophageal carcinoma and an early gastric cancer, which were treated by esophagectomy with reconstruction followed by endoscopic mucosal resection, respectively.
A 66-year-old man was admitted to the hospital with a diagnosis of ulcerative type of cancer in the lower thoracic esophagus. He underwent an esophagectomy together with 3-field lymph node dissection and reconstruction using the stomach through posterior mediastinum on 9 th November, 1994. Pathological study revealed that the lesion was undifferentiated carcinoma invading adventitia with lymph node metastasis. The patient was followed up without any adjuvant therapy. Seven months after the surgery, a superficially elevated lesion was detected in posterior wall of the antrum endoscopically. The gastric lesion was treated by endoscopic mucosal resection, which was found to be curative, because the lesion was well differentiated tubular adenocarcinoma limited in the mucosa and without vascular invasion. There have been no signs of recurrence 32 months after the surgery.
Undifferentiated esophageal carcinomas are uncommon among esophageal tumors. It is believed that the patients with the disease can not expect to survive for more than one year after operation. However, an improvement of prognosis may be afforded by strict follow-up of clinical course and early detection and treatment of the second malignancy.
