J Korean Radiol Soc.  2002 Aug;47(2):205-211. 10.3348/jkrs.2002.47.2.205.

Remote Metastasis to the Gastric Cardia in Esophageal Carcinoma: CT Findings

Affiliations
  • 1Department of Radiology, College of Medicine, Chungnam National University, Korea.
  • 2Department of Internal Medicine, College of Medicine, Chungnam National University, Korea.
  • 3Department of General Surgery, College of Medicine, Chungnam National University, Korea.
  • 4Department of Pathology, College of Medicine, Chungnam National University, Korea.
  • 5Department of Radiology, Our Lady of Mercy Hospital, College of Medicine, Catholic University, Korea.

Abstract

PURPOSE
To assess the CT findings of remote metastasis to the gastric cardia in patients with esophageal carcinoma.
MATERIALS AND METHODS
Among patients with esophageal carcinomas treated between June 1994 and May 1999, five males aged 65-75 (mean, 67.4) years with histologically proven remote metastasis to the gastric cardia from esophageal squamous cell carcinoma, detected at surgery (n=2) or endoscopic biopsy (n=3), underwent CT scanning. We retrospectively evaluated the findings in terms of the location, size and appearance of each lesion and the presence or absence of associated lymphadenopathy.
RESULTS
The primary esophageal carcinomas were located in the middle third (n=4) and lower third (n=1) of the esophagus. All five gastric metastases were solitary and occurred in the gastric cardia, and were separated from the primary tumors. CT showed that the metastases ranged in size from 4.2 to 8.0 (mean, 6.7) cm, and all were larger than the primary tumors. All were ulcerated, and in four cases there was associated abdominal lymphadenopathy. They were all well defined, poorly enhanced, submucosal masses that were endogastric in three cases and exogastric in two. The latter were difficult to differentiate from extrinsic masses compressing the gastric cardia.
CONCLUSION
Our results suggest that when a submucosal gastric cardial mass with associated lymphadenopathy is detected by CT during the initial staging or follow-up evaluation of esophageal carcinoma, remote gastric metastasis should be considered.

Keyword

Stomach, CT; Stomach, neoplasms

MeSH Terms

Biopsy
Carcinoma, Squamous Cell
Cardia*
Esophagus
Follow-Up Studies
Humans
Lymphatic Diseases
Male
Neoplasm Metastasis*
Retrospective Studies
Tomography, X-Ray Computed
Ulcer
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