Salvage gastrectomy for perforated gastric intramural metastasis after definitive chemoradiotherapy for distal esophageal squamous cell carcinoma: a case report.
- 1Department of Surgery, Phramongkutklao Hospital, Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand.
Abstract
Gastric intramural metastasis from esophageal squamous cell carcinoma (ESCC) is rare, and chemotherapy-associated perforation is exceptionally uncommon. We report a case of a 67-year-old man with distal ESCC and a separate cardia squamous cell carcinoma (SCC). He declined esophagectomy and received definitive chemoradiotherapy (dCRT) with paclitaxel, carboplatin, and 50.4 Gy radiotherapy. During the second chemotherapy cycle, the cardia tumor perforated and was treated by emergency omental patch repair. Chemoradiotherapy was subsequently completed. Three months after completion of dCRT, the esophageal lesion showed a clinical complete response, whereas residual cardia disease persisted. Extended total gastrectomy with splenectomy achieved R0 resection; pathology showed a 6-cm pT3 moderately differentiated SCC with partial treatment response and 0/12 positive nodes. Postoperative nivolumab was administered. This case illustrates a staged salvage strategy for persistent gastric intramural disease after definitive chemoradiotherapy.
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BibTeX
@article{leelapatanadit2026salvage,
title = {{Salvage gastrectomy for perforated gastric intramural metastasis after definitive chemoradiotherapy for distal esophageal squamous cell carcinoma: a case report.}},
author = {Jirat Leelapatanadit and Sawanya Sangthong and Rawat Waratchanont and Wichitra Asanprakit and Viriya Kaewkangsadan and Sukchai Satthaporn},
journal = {Journal of surgical case reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag932},
url = {https://europepmc.org/article/MED/42899251},
note = {CC BY},
}
RIS
TY - JOUR
TI - Salvage gastrectomy for perforated gastric intramural metastasis after definitive chemoradiotherapy for distal esophageal squamous cell carcinoma: a case report.
AU - Jirat Leelapatanadit
AU - Sawanya Sangthong
AU - Rawat Waratchanont
AU - Wichitra Asanprakit
AU - Viriya Kaewkangsadan
AU - Sukchai Satthaporn
PY - 2026
DA - 2026/10/19
JO - Journal of surgical case reports
DO - 10.1093/jscr/rjag932
UR - https://europepmc.org/article/MED/42899251
AB - Gastric intramural metastasis from esophageal squamous cell carcinoma (ESCC) is rare, and chemotherapy-associated perforation is exceptionally uncommon. We report a case of a 67-year-old man with distal ESCC and a separate cardia squamous cell carcinoma (SCC). He declined esophagectomy and received definitive chemoradiotherapy (dCRT) with paclitaxel, carboplatin, and 50.4 Gy radiotherapy. During the second chemotherapy cycle, the cardia tumor perforated and was treated by emergency omental patch repair. Chemoradiotherapy was subsequently completed. Three months after completion of dCRT, the esophageal lesion showed a clinical complete response, whereas residual cardia disease persisted. Extended total gastrectomy with splenectomy achieved R0 resection; pathology showed a 6-cm pT3 moderately differentiated SCC with partial treatment response and 0/12 positive nodes. Postoperative nivolumab was administered. This case illustrates a staged salvage strategy for persistent gastric intramural disease after definitive chemoradiotherapy.
SN - 2042-8812
ER -