Carcinoma of the gastric cardia in young people

Carcinoma of the gastric cardia is usually considered a disease of middle-aged or elderly patients and is rarely suspected in young individuals. However, six cases are reported in patients under 45 years of age. The youngest was 26. A review of patient records revealed no obvious predisposing factor to account for the development of cancer at an early age. In four cases, double-contrast upper gastrointestinal examinations revealed a polypoid mass at the cardia. In two cases, however, the true origin of a tumor arising at the cardia was only recognized by obliteration of the normal anatomic landmarks at the cardia associated with irregular areas of ulceration. In all six cases, the tumor extended into the distal esophagus. Five patients presented with dysphagia. Careful radiographic evaluation of the cardia and fundus is therefore essential to rule out an underlying carcinoma of the cardia in all patients with dysphagia, regardless of age.