A Case of Metachronous Double Cancer of the Esophagus and Stomach.

Abstract

We experienced a case of metachronous double cancer of the esophagus and stomach. This patient showed good prognosis with sequential adjuvant chemoradiation therapy. A 69-year-old man with a chief complaint of epigastralgia was admitted to our hospital in November 2009. Upper gastrointestinal endoscopic examination showed type 3 gastric cancer in the antrum. Pathological examination indicated that the tumor was an adenocarcinoma. After distal partial gastrectomy was performed, adjuvant chemotherapy with docetaxel and S-1 were administered. One year after surgery, upper endoscopic examination revealed a thoracic type 0-II esophageal tumor in the middle esophagus. Pathological examination indicated that this tumor was a squamous cell carcinoma. Laparotomy showed wide dissemination, and the tumor was diagnosed as metastasis from adenocarcinoma on the basis of intraoperative rapid pathological examination. Six courses of chemotherapy with CDDP and S-1 were effective, but 4 months later, the esophageal cancer recurred.Therefore, 4 courses of the same chemotherapy regimen were administered. The patient showed disease progression. Sequential radiation therapy for the esophageal cancer successfully reduced the size of the main tumor and metastatic lymph nodes. Two months later, endoscopic examination indicated recurrence of the esophageal cancer. Therefore, we started treatment with combined therapy with DTX and CDGP.