[A case of esophageal squamous cell carcinoma with submucosal tumor-like tumor due to direct invasion of the gastric wall].

We encountered a case of esophageal squamous cell carcinoma (ESCC) with submucosal tumor (SMT)-like tumor in the cardia of the stomach, formed by direct invasion of the gastric wall. The patient was a 72-year-old woman with dysphagia. Upper endoscopy showed a giant SMT-like tumor in the cardia of the stomach, and imaging studies revealed metastasis to the nearby and distant lymph nodes. Although squamous cell carcinoma was diagnosed by biopsy of the SMT-like tumor in the gastric cardia, gastric involvement was suspected via metastasis to the perigastric lymph nodes or direct invasion of the gastric wall by the ESCC, because the primary lesion of ESCC could not be identified during the examinations. FP chemotherapy (days 1-5, 800 mg/m2 5-fluorouracil[5-FU]; day 1, 80 mg/m2 cisplatin[CDDP]) was initiated for the treatment of ESCC. Considering the risk of invasion, we discontinued the chemotherapy and performed lower esophagectomy and cardiectomy. Pathologically, the primary lesion of the ESCC was detected in the abdominal esophagus, and the SMT-like tumor in the gastric cardia was determined to result from direct invasion of the gastric wall by the ESCC. We herein report a rare case of ESCC with an SMT-like tumor in the gastric cardia formed by direct invasion of the gastric wall.