Recurrence of Esophageal Residual Gastric Anastomosis With Cervical Lymph Node Metastasis Following Laparoscopic Proximal Gastrectomy for Early-Stage Gastric Cancer.

Proximal gastrectomy (PG) is performed in Japan for early-stage gastric cancer in the upper stomach using various reconstruction methods. Although the location and frequency of lymph node metastasis in natural esophagogastric junction cancers have been widely discussed, lymph node metastasis of local recurrence to the esophagogastric anastomosis after PG has not been reported. We present the case of a 77-year-old man who underwent laparoscopic PG for early-stage gastric adenocarcinoma. Local recurrence was detected at the esophageal residual gastric anastomosis two years later. Positron emission tomography/computed tomography revealed suspected cervical lymph node metastasis. Intraoperative rapid histopathology confirmed adenocarcinoma, prompting esophagogastrectomy with three-field lymph node dissection. This report is the first to document cervical lymph node metastasis arising from local recurrence at the esophageal residual gastric anastomosis following PG.