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Eur J Cardiothorac Surg 2004;26:1223-1225
© 2004 Elsevier Science NL

Case report

Thirteen cases with intramural metastasis to the stomach in 1259 patients with oesophageal squamous cell carcinoma

^a Division of Cancer Medicine, Department of Surgical Oncology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
^b Keiyuukai Sapporo Hospital, Hokkaido, Japan

Received 10 April 2004; received in revised form 3 August 2004; accepted 23 August 2004.

^* Corresponding author. Address: Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8648, Japan. Tel.: +81 11 706 7714; fax: +81 11 706 7158. (E-mail: yuma-ebi{at}wc4.so-net.ne.jp).

Among a total of 1259 patients with oesophageal cancer who underwent surgical resection, intramural metastasis (IMM) was verified in 93 patients (7.4%), of which IMM to the stomach (IMMS) constituted 13 patients (1.0%). In all 13 cases, the primary cancer was located in the middle or lower thoracic oesophagus and all had lymph nodes metastasis, while 12 of the 13 (92.3%) had lymphatic invasion. In our series, as the depth of invasion advanced, the number of patients with IMM or IMMS increased, although even superficial IMMS was revealed. The gross appearance of the metastatic tumours in the stomach resembled submucosal tumours. The possibility exists that metastatsis via a lymphatic duct allows expansive growth in the gastric submucosae. These findings suggest that oesophageal cancer metastasizes to the stomach via a lymph duct. In conclusion, oesophageal cancer with lymphatic invasion may lead to IMM and IMMS. Therefore, careful examination for the existence of IMM, including the stomach, is required.

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