Esophageal cancer associated with primary early gastric cancer.

We treated 114 Japanese patients with primary esophageal cancer during a period between 1965 and 1981; and 5 (4.4 per cent) were associated with simultaneous primary gastric cancer. Four of the 5 patients were treated surgically and all of the coexisting gastric cancers were in the early stage. The presence of gastric lesions was correctly diagnosed preoperatively in two of four patients. Surgical reconstruction was done to prepare a new route for food ingestion using a segment of ileo-ascending colon. In the other two patients, gastric tube was prepared, because gastric cancers were detected by chance in the resected specimens in these patients. Based on our experiences, we wish to stress the importance of detailed preoperative gastric examination and of careful intraoperative inspection of the gastric mucosa in patients with esophageal cancer whose preoperative gastric examination provides inconclusive evidence due to the presence of esophageal stenosis.