Gastric cardia metastasis in esophageal carcinoma

To our knowledge, esophageal carcinoma that is metastatic to the gastric cardia has rarely been described in the radiologic literature. We examined seven patients who had a solitary metastasis in the gastric cardia that had spread from esophageal carcinoma. Five of the gastric lesions were synchronous with the primary lesion, and two developed after the primary tumor had been detected. Radiographically, the gastric lesion appeared as a submucosal mass in five patients and appeared to simulate a primary gastric carcinoma in the other two patients. The metastases had probably disseminated through the submucosal lymphatic system. Because the presence of a gastric metastasis may affect a patient's therapy, radiographic examination of the gastric fundus should be a routine part of the initial staging and/or follow-up evaluation of esophageal carcinoma.