An 81-year-old woman was admitted to the hospital because of a 4-month history of appetite loss. Radiologic and endoscopic examinations revealed an esophageal carcinoma with a giant gastric submucosal tumor. Distal esophagectomy and proxymal gastrectomy with esophagogastrostomy through the intra-thoracic route were performed. The resected gastric submucosal tumor was 8.0×7.8×4.8cm in size, and histologically moderately differentiated squamous cell carcinoma. It was thought that the gastric lesion was intramural metastasis of the esophageal carcinoma. Operative and histological findings revealed no lymph node metastasis. She was discharged and has been recurrence free for 2 years and 2 months after the surgery.
Esophageal carcinoma with intramural gastric metastasis is relatively rare in a frequency of 1.0_??_4.7%. It is often observed that some metastases are larger than primary esophageal tumors, and others show a rapid growth. Patients who have esophageal carcinoma should receive careful examination of the stomach, even though the esophageal carcinoma is in an early stage and there is no lymph node metastasis.