[Intramural gastric metastasis of esophageal squamous cell carcinoma: an analysis of imaging findings and clinicopathological features]

Zhonghua Zhong Liu Za Zhi. 2017 Jul 23;39(7):509-513. doi: 10.3760/cma.j.issn.0253-3766.2017.07.006.
[Article in Chinese]

Abstract

Objective: To discuss the imaging findings and clinicopathological features of the intramural gastric metastasis (IGM) of esophageal squamous cell carcinoma. Methods: The imaging findings of 11 patients with IGM confirmed by surgical pathology were reviewed retrospectively, and compared with clinicopathological features. Of the 11 cases, eight underwent upper gastrointestinal radiography, ten underwent contrast enhanced computed tomography (CT) scans and one underwent plain CT scanning. Results: In all 11 cases, the primary cancer was located in the middle or lower thoracic esophagus, and nine of 11 had lymph nodes metastasis. All of the 11 tumors within the stomach were located in the upper one-third of the stomach, with the maximum diameter of tumor ranging from 1.0 cm to 12.0 cm. Gastrointestinal radiography showed irregular filling defect of the stomach in three cases with clear border resembled a submucosal tumor. Mucosal folds of the stomach were irregular and rough in two cases. On CT scans, nodule or mass in the gastric wall was found in seven patients, and two of them were accompanied with ulcer formation. Eccentric or nodular gastric wall thickening was found in the other two patients. All of them were heterogeneous mild-to-moderate enhancement. Conclusions: The imaging appearances of IGM have certain characteristics, but final diagnosis depends on histopathology. The prognosis of IGM was extremely poor, so the preoperative diagnosis is very important to guide clinical treatment.

目的: 探讨食管鳞癌胃壁内转移(IGM)的影像学表现和临床病理特征。 方法: 回顾性分析经手术病理证实的11例食管鳞癌IGM的术前影像学检查,其中消化道造影检查8例,CT增强扫描10例,CT平扫1例。分析食管鳞癌IGM的影像学表现和临床病理特征。 结果: 11例食管鳞癌的原发灶均位于食管中下段,IGM灶均位于胃部上1/3处(食管胃连接处、胃底或胃小弯侧),最大径为1.0~12.0 cm,伴有淋巴结转移9例。消化道造影显示,3例表现为胃壁不规则充盈缺损,边界清楚,类似于黏膜下肿瘤;2例仅表现为黏膜粗糙紊乱。CT检查显示,7例表现为胃壁内结节或肿物,其中2例伴有溃疡形成,2例表现为胃壁不对称或结节状增厚;7例增强扫描均表现为不均匀轻中度强化。 结论: IGM的影像学表现具有一定特征性,但确诊仍需手术病理。食管鳞癌IGM预后较差,术前诊断对于指导临床治疗和判断预后有重要的临床意义。.

Keywords: Esophageal neoplasms; Intramural gastric metastasis; Neoplasms, squamous cell; Pathology, clinical; Tomography; X-ray computed.

MeSH terms

  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / secondary*
  • Contrast Media
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / pathology*
  • Humans
  • Lymphatic Metastasis
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms / diagnostic imaging
  • Stomach Neoplasms / secondary*
  • Tomography, X-Ray Computed

Substances

  • Contrast Media