A surgical case of primary esophageal adenocarcinoma in ectopic gastric mucosa which was located in the upper intrathoracic region of the eosphagus is described in this report.
The patient was an 85-year-old male. He started to suffer from difficulty of swallowing since April of 1991. Endoscopy was performed and a tumor narrowing the entire circumference was observed on the left side of the posterior wall of the esophagus located 20cm from the incisor line. Biopsy diagnosed this case as poorlydifferentiated adenocarcinoma. On May 9, 1991, blunt dissection without thoracotomy was performed, followed by postmediastinum esophagogastrostomy. The surgical findings were A₂N_xM₀Pl_x. The postoperative course was unevent ful and the patient was discharged from the hospital on the 39th day after surgery. Histopathologically this tumor was adenocarcinoma with a variety of histological patterns such as highly-moderately and poorlydifferentiated and mucinous types. Stratified squamous epithelium was present on the oral and anal sides of the lesion. Columnar epithelium resembling that of gastric mucosa was also found in the tumor. Given these findings, this case was diagnosed as having an adenocarcinoma in ectopic gastric mucosa.
Only five cases of malignancy originating from ectopic gastric mucosa have been reported in Japan including the present case. The course of the patient with ectopic gastric mucosa should be carefully observed.