Heterochronic gastric adenosquamous carcinoma combined with colonic adenoma: A case report

Metachronous gastric cancer usually refers to a tumor that occurs in the stomach more than half a year after esophageal cancer surgery, and metastasis of primary esophageal cancer should be excluded. There are few reports of metachronous gastric adenosquamous carcinoma with signet ring cell carcinoma combined with early tubular adenoma of the colon after esophageal cancer surgery, which has a high degree of malignancy. This is also the reason for the poor treatment results.

A 54-year-old male patient was admitted to the hospital with "dysphagia obstruction". Seven years ago, the patient was diagnosed with well-differentiated squamous cell carcinoma in the middle esophagus (T4N1M0 stage) and left gastric lymph node metastasis. In the final resection of the esophageal cancer, no residual cancer tissue was found in the esophageal and gastric stump. The patient's medical history 7 years ago (preoperative gastroscopy and other examinations) revealed no gastric tumor. Combined with the patient's history, the diagnosis of recurrent esophageal cancer was made on this admission. The final pathological results were surprising: Metachronous gastric adenosquamous carcinoma with signet ring cell carcinoma combined with early tubular adenoma of the colon. Considering the high malignancy of the tumor, the complexity of the second operation, and many complications, the patient received chemotherapy.

He had a history of esophageal cancer resection. Gastroenteroscopy should be performed simultaneously to avoid missed diagnosis and misdiagnosis.