부산대학교 도서관

A 54-year-old man with esophageal cancer (cT2N0M0) and subcardial gastric cancer (cT1N0M0) underwent simultaneous curative resection by thoracotomy and laparotomy. Five years after the surgery, superficial gastric cancer was detected in the antral portion of the gastric tube, and was resected by endoscopy (endoscopic submucosal dissection [ESD]). Pathological examination showed a well-to-moderately differentiated adenocarcinoma slightly invading the submucosal layer (SM1). Total gastric tube resection was not performed because of poor respiratory function. At 2 years 2 months after the ESD, local recurrence was diagnosed by endoscopy. S-1 chemotherapy was not effective, and the patient died of respiratory failure 6 months after the chemotherapy. Autopsy revealed diffuse spread of poorly differentiated adenocarcinoma, including the entirety of the gastric tube, lung, pleura, heart muscle, bone marrow, and abdominal lymph nodes.