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Adenocarcinoma of the Gastric Cardia with Multiple Skip Esophageal Metastases: A Case Report

胃賁門癌併多發性食道轉移性病灶:一病例報告

摘要


胃賁門癌在胃癌中是屬於較特定的部分,其發生率逐年上升,死亡率及復發率高,且易於侵犯食道。根據報告,約八成病人有食道下段的侵犯,其中以腫瘤直接侵犯或沿黏膜下淋巴腺轉移為主。至於往食道近端的侵犯造成多發性遠距離的轉移則較少見。我們報告一名62歲病患因近三個月來發生吞嘸困難及體重減輕而就醫。內視鏡檢查發現賁門腫瘤合併多發性食道內之跳躍轉移。食道最上方的病壯距門齒21公分而距賁門腫瘤17公分。手術發現腹腔內已有腫瘤散佈。在胃賁門癌併食道侵犯的患者中,此多發性遠距離的轉移實屬罕見,特提出報告。

關鍵字

腺癌 胃賁門 跳躍轉移

並列摘要


Adenocarcinoma of the gastric cardia has a propensity of lower esophageal invasion and lymph node metastasis, but multiple skip esophageal metastases are rarely seen. We present a 62- year-old male patient who had suffered from dysphagia and weight loss for 3 months. Esophagoscopy revealed a gastric cardiac tumor with multiple skip esophageal lesions. Biopsies of the main tumor and skip lesions showed adenocarcinoma. The first lesion in esophagus was located at 21 cm from the incisor teeth and was 17 cm away from the main tumor. An advanced tumor with multiple intraperitoneal seeding was noted at laparotomy performed thereafter. The distant skip esophageal metastases may be the manifestation of malignant behavior and locally advanced main tumor.

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