Early detection of esophageal cancer and advance in therapeutic techniques increase the survival of esophageal cancer patients; therefore, reconstructed gastric tube cancer may become a special issue for oncologists. We present a case of esophageal cancer after esophagectomy and gastric tube reconstruction with long-term remission who developed a second cancer in reconstructed gastric tube Surgical intervention is the first priority choice of treatment, and endoscopic mucosal resection (EMR) for early cancer might result in good prognosis. Radiotherapy should be considered for inoperable patients or as an adjuvant mode after surgery.