A Case of Primary Esophageal Adenocarcinoma in the Upper Thoracic Esophagus

Hiroki Sunagawa¹⁾²⁾, Koji Kawakami¹⁾, Susumu Inamine¹⁾, Tetsuo Touyama¹⁾, Hisamitsu Zaha¹⁾, Naoto Oshiro¹⁾ and Tadashi Nishimaki²⁾

Department of Surgery, Nakagami Hospital¹⁾
Department of Digestive and General Surgery, University of the Ryukyus²⁾

We describe a case of primary upper thoracic esophageal adenocarcinoma with gastric adenocarcinoma. A 59-year-old man admitted for nasal bleeding was found in gastroesophageal endoscopy to have two pedunculated polyps in a slightly depressed lesion (0-Ip+0-IIc) in the upper thoracic esophagus and a broad tumor in a slightly depressed lesion (0-IIa+IIc) in the middle gastric body on the major curvature. Biopsies showed moderately differentiated adenocarcinoma of the esophagus and poorly differentiated adenocarcinoma of the stomach. Computed tomography showed an enlarged lymph node (106 rec L) diagnosed as metastasis. Tumors were resected by a transthoracic esophagectomy and total gastrectomy with D2 lymph nodes dissection. There were no barrett's mucosa nor ectopic gastric mucosa in the resected specimen. The peripheral epithelium in the esophageal tumor was consistent with carcinoma in situ differentiating into adenocarcinoma. Such a case of primary esophageal adenocarcinoma is rare.

Key words
esophageal adenocarcinoma, histogenesis of esophageal cancer, gastric cancer

Reprint requests
Hiroki Sunagawa Department of Surgery, Nakagami Hospital
6-25-5 Chibana, Okinawa, 904-2195 JAPAN

Accepted
March 26, 2008

To read the PDF file you will need Abobe Reader installed on your computer.