From Oct. 1982 to Sep. 1990, 450 cases of tissue proven carcinoma of the esophagus were treated at Taichung Veterans General Hospital, seven of these were primary adenocarcinoma of the esophagus, but only two had been diagnosed pre-operatively (by endoscopy). Most primary lesions may have originated from the submucosal gland of esophagus. The pathological characteristics included submucosal tumor infiltration without dysplasia of epithelium around the tumor margin and absence of Barrentt's epithelium. Five of the seven patients received surgical resection and four patients showed negative lymph node metastasis. Three of the node negative patients are still alive 23, 29 and 58 months after the operation. Thus long term survival may be expected after surgical resection in node negative primary adenocarcinoma of the esophagus.