Esophageal Squamous Cell Carcinoma with Intragastric Metastasis Invading Liver: A Case Report
Keywords:
Early-stage esophageal carcinoma, Gastric metastasis, Intramural gastric metastasis, Liver invasionAbstract
Esophageal squamous cell carcinomas often metastasized to lymph nodes and distant organs. The incidence of metastasis to the stomach from esophageal cancer was rare. However, early-stage esophageal carcinoma with gastric metastasis is very rare. We report a case of submucosal esophageal SCC arising in the mid-thoracic esophagus with a large metastasis tumor in the gastric cardia invading liver. A 54 year-old Thai male presented with sudden epigastrium pain for 3 days. He had melena 1 month previously. Endoscopic examination revealed a 0.5 cm small ulcerative lesion squamous cell carcinoma and a giant gastric tumor at cardia. Computed tomography showed that the gastric tumor was directly invading the liver. He underwent Ivor Lewis esophagectomy and wedge resection left lobe liver. Final pathological findings were superficial esophageal carcinoma invading the submucosal layer with gastric mass involving the gastric submucosa, the muscular propria, and partially extended into the adjacent liver. After chemotherapy cycle 3, computed tomography showed liver metastasis. The outcome for patients with esophageal carcinoma who have gastric metastasis is very poor, even after surgery and chemotherapy. Optimal management of gastric metastasis from esophageal cancer is not established yet.
References
Namikawa T, Hanazaki K. Clinicopathological features and treatment outcomes of metastatic tumors in the stomach. Surg Today 2014;44:1392-9.
Saito T, Iizuka T, Kato H, et al. Esophageal carcinoma metastatic to the stomach. A clinicopathologic study of 35 cases. Cancer 1985;56:2235-41.
Kim GH, Ahn JY, Jung HY, et al. Clinical and endoscopic features of metastatic tumors in the stomach. Gut Liver. 2015;9:615.
Bento LH, Minata MK, Batista CP, et al. Clinical and endoscopic aspects of metastases to the gastrointestinal tract. Endoscopy 2019;51:646-52.
Kobayashi O, Murakami H, Yoshida T, et al. Clinical diagnosis of metastatic gastric tumors: clinicopathologic findings and prognosis of nine patients in a single cancer center. World J Surg 2004;28:548-51.
Linda K, Green M. Hematogenous metastasis to the stomach. Cancer 1990;65:1596-600.
Namikawa T, Munekage E, Ogawa M, et al. Clinical presentation and treatment of gastric metastasis from other malignancies of solid organs. Biomed Rep 2017;7:159-62.
De Palma GD, Masone S, Rega M, et al. Metastatic tumors to the stomach: clinical and endoscopic features. World J Gastroenterol 2006;12:7326.
Koide N, Adachi W, Koike S, et al. Synchronous gastric tumors associated with esophageal cancer: a retrospective study of twenty-four patients. American J Gastroenterol 1998;93:758-62.
jp JGCAjkk-ma. Japanese classification of gastric carcinoma: 3rd English edition. Gastric cancer. 2011;14:101-12.
Talerman A, Woo‐Ming MO. The origin of squamous cell carcinoma of the gastric cardia. Cancer 1968;22:1226-32.
Glick SN, Teplick SK, Levine MS. Squamous cell metastases to the gastric cardia. Gastrointest Radiol 1985;10:339-44.
Hashimoto T, Arai K, Yamashita Y, et al. Characteristics of intramural metastasis in gastric cancer. Gastric Cancer 2013;16:537-42.
Nakazawa N, Fukuchi M, Sakurai S, et al. Mucosal esophageal squamous cell carcinoma with intramural gastric metastasis invading liver and pancreas: a case report. Int Surg 2014;99:458-62.
Kuwano H, Baba K, Ikebe M, et al. Gastric involvement of oesophageal squamous cell carcinoma. Brit J Surg 1992;79:328-30.
Takubo K, Sasajima K, Yamashita K, et al. Prognostic significance of intramural metastasis in patients with esophageal carcinoma. Cancer 1990;65:1816-9.
Kato H, Tachimori Y, Watanabe H, et al. Intramural metastasis of thoracic esophageal carcinoma. Int J Cancer 1992;50(1):49-52.
Ebihara Y, Hosokawa M, Kondo S, et al. Thirteen cases with intramural metastasis to the stomach in 1259 patients with oesophageal squamous cell carcinoma. Eur J Cardiothorac Surg 2004;26:1223-5.
Nishimaki T, Suzuki T, Tanaka Y, et al. Intramural metastases from thoracic esophageal cancer: local indicators of advanced disease. World J Surg 1996;20:32-7.
Hosoda S, Nagayo T, Suchi T, et al. Submucosal extension with spherical appearance of esophageal carcinoma into gastric cardia clinico-pathologic study of four cases. Tohoku J Experiment Med 1971;105:381-90.
Oba K, Paoletti X, Alberts S, et al. Disease-free survival as a surrogate for overall survival in adjuvant trials of gastric cancer: a meta-analysis. J Natl Cancer Inst 2013;105:1600-7.
Kataoka K, Nakamura K, Mizusawa J, et al. Surrogacy of progression-free survival (PFS) for overall survival (OS) in esophageal cancer trials with preoperative therapy: Literature-based meta-analysis. Eur J Surg Oncol 2017;43:1956-61.
Ku GY. Systemic therapy for esophageal cancer: chemotherapy. Chin Clin Oncol 2017;6:49.
Wagner A, Syn N, Moehler M, et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 2017;8:Art No: CS004604.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 The Royal College of Surgeons of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.
