Gastric carcinoma.

A 65-year-old man with a history of a stage III laryngeal cancer treated with chemoradiation was undergoing screening esophagoscopy. On transnasal esophagoscopy (TNE), an ulcerated, erythematous mass was seen in the distal body of the stomach (figure). Biopsy at the time of TNE revealed that the mass was a gastric adenocarcinoma.

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While the overall incidence of gastric carcinoma has decreased by 75% in the United States during the past 80 years, the incidence of proximal gastric and gastroesophageal junction tumors (which have a poorer prognosis) has increased rapidly. The vast majority of gastric tumors are adenocarcinomas. Because patients often have no symptoms or only vague gastrointestinal complaints, most gastric tumors present at an advanced stage. Cure is dependent on complete resection, and early diagnosis greatly improves survival. In the case described here, the cancer was detected at an early stage. The lesion was removed, and the patient's prognosis for survival was good.

Suggested reading

Gallo A, Cha C. Updates on esophageal and gastric cancers. World J Gastroenterol 2006; 12:3237-42.

Tan YK, Fielding JW. Early diagnosis of early gastric cancer. Eur J Gastroenterol Hepatol 2006; 18:821-9.

Catherine J. Rees, MD; Peter C. Belafsky, MD, PhD

From the Center for Voice and Swallowing, University of California-Davis, Sacramento, Calif.