A Case of Esophago-Gastric Junctional Carcinoma with Intramural Invasion and Cervical Lymph Node Metastasis

The patient was a 66-year-old man who was diagnosed with a type 3 lesion in the esophago-gastric junction and a type 1 lesion in the upper esophagus. Both the lesions were diagnosed as adenocarcinoma. Chest and abdominal computed tomography examinations pointed out No. 106recL lymph node metastasis. He was diagnosed with Stage III esophago-gastric cancer( T2N3M0)and treated by a laparoscopic subtotal esophagectomy with 2-field lymph node dissection. The histological diagnosis was type 3 adenocarcinoma in the esophago-gastric junction with intramural metastasis and massive lymph node metastasis(No. 1, No. 2, No. 101L, No. 106recL). A vertical connection of venous invasion in the submucosal layer was also observed from the primary lesion to the cervical esophagus via intramural invasion. Treatment based on esophageal cancer is necessary in advanced esophago-gastric cancers with intramural metastasis or massive venous invasion.