Thirteen cases with intramural metastasis to the stomach in 1259 patients with oesophageal squamous cell carcinoma.

Among a total of 1259 patients with oesophageal cancer who underwent surgical resection, intramural metastasis (IMM) was verified in 93 patients (7.4%), of which IMM to the stomach (IMMS) constituted 13 patients (1.0%). In all 13 cases, the primary cancer was located in the middle or lower thoracic oesophagus and all had lymph nodes metastasis, while 12 of the 13 (92.3%) had lymphatic invasion. In our series, as the depth of invasion advanced, the number of patients with IMM or IMMS increased, although even superficial IMMS was revealed. The gross appearance of the metastatic tumours in the stomach resembled submucosal tumours. The possibility exists that metastasis via a lymphatic duct allows expansive growth in the gastric submucosae. These findings suggest that oesophageal cancer metastasizes to the stomach via a lymph duct. In conclusion, oesophageal cancer with lymphatic invasion may lead to IMM and IMMS. Therefore, careful examination for the existence of IMM, including the stomach, is required.