Esophageal carcinoma metastatic to the stomach. A clinicopathologic study of 35 cases

Abstract

Esophageal carcinoma metastatic to the stomach was analyzed in 35 patients. Ten were discovered in surgical specimens and 25 at autopsy. All patients were men with a mean age of 62 years. Primary lesions were most frequently located in the middle of thoracic esophagus and were larger than 7 cm. Undifferentiated carcinoma was found in 29% of the patients. Local spread of the primary lesions to neighboring structures was seen in 34%. Lymphatic invasion, and intramural metastases within the esophagus, as well as lymph node metastases, were predominant. Metastatic lesions within the stomach were mostly located in the gastric cardia, were less than 2 cm or more than 4 cm in size, and resembled submucosal tumors. Gastric metastases occasionally spread from the submucosa to neighboring structures. In spite of aggressive treatment, the prognosis was extremely poor because of multiple spread of carcinoma to local regions, lymph nodes, and distant organs. The clinicopathologic characteristics of this disease and possible treatment are discussed.

Metastatic cancer to the stomach

“…The degree to which the stomach is compromised by metastases from esophageal cancer has been described in a series of necropsies [3,8,[21][22][23][24], and the percentage rate has been progressively increasing, ranging from 2.4% to 15.2%. The significant number of cases reported in surgical specimens from patients who had undergone operation in Japan is really noteworthy [7,8,[25][26][27][28].…”

“…The significant number of cases reported in surgical specimens from patients who had undergone operation in Japan is really noteworthy [7,8,[25][26][27][28].…”

“…To the best of our knowledge, the literature includes no reports of similar cases with EGD diagnosis. Saito et al [8] describe nine identical cases, which were, however, detected during necropsy.…”

Mucosal Esophageal Squamous Cell Carcinoma With Intramural Gastric Metastasis Invading Liver and Pancreas: A Case Report

“…[1][2][3][4][5][6] Our previous study classified gastric involvement by esophageal squamous cell carcinoma pathologically into the following four patterns: (1) gastric invasion from metastatic lymph nodes, (2) intramural metastasis, (3) direct gastric wall involvement by the primary tumor, and (4) intraepithelial spread to the gastric mucosa. 4 Another study reported detection of IGMs in 8/274 (2.9%) patients at autopsy, none of whom had had any evidence of gastric tumors when operated upon while still alive.…”

“…However, intramural gastric metastasis (IGM) is rare, the incidence in surgical specimens being 1% to 4.58%. [1][2][3][4][5][6] It is not unusual for rapidly growing IGMs to be larger than their primary esophageal carcinomas. IGMs have an extremely poor prognosis.…”