International Surgery Journal | February 2023 | Vol 10 | Issue 2 Page 299
International Surgery Journal
Ramírez JAT et al. Int Surg J. 2023 Feb;10(2):299-302
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Case Report
Peritoneal carcinomatosis as a pathway of metastatic dissemination in a
patient with gastroesophageal junction cancer: case report and review
José Á. Tovar Ramírez
1
, R. Lucano Valdés Ramos
2
, Miguel Á. Nava Jiménez
3
,
Obed H. Grajeda Chávez
1
, Luis Arturo Camarillo R.
4
, Mariano Tovar Ponce
5
,
Emmanuel Gómez García
5
, Mauricio Martínez Hurtado
5
, Daniela Rodríguez Ramírez
1
,
Ludwigvan A. Bustamante S.
1
*
INTRODUCTION
An important characteristic of esophageal and EGJC is
that metastases identified in more than 50% of patients at
time of diagnosis, while more than 30% will develop
metastases during the course of the disease. this being
one of main causes of death in these patients.
1,2
Most
frequently described sites of metastases are in descending
order: liver, distant lymph nodes, lung, bone, and brain.
3,5
There are limited studies reporting differences in
metastatic spread based on the location of the primary
tumor, for example, upper EC versus cancer of the lower
esophagus or esophagus-gastric junction.
6,7
However, it
has been described that peritoneal carcinomatosis is a
slightly less frequent form of metastatic presentation
when it comes to classic esophageal adenocarcinoma,
however it is more common to find it when it comes to
adenocarcinoma of the esophageal-gastric junction.
8-10
CASE REPORT
In the present work we report the case of a 78-year-old
male, his comorbidities are arterial hypertension under
pharmacological treatment, glaucoma under management
with trabatan and timolol, chronic low back pain under
management with buprenorphine and celecoxib patches,
gastroesophageal reflux disease in occasional PPI
management. Initially, the patient was identified in the
general medicine consultation and sent to the endoscopy
service who, after performing an upper digestive
endoscopy and taking biopsies, integrated the diagnosis
of Barrett's esophagus with high-grade dysplasia and
stenosis of the distal third of the esophagus. The study
protocol was carried out during the pandemic, so the
ABSTRACT
The oesophageal adenocarcinoma is an increasing pathology in the last decade, predominantly in the western
population. A characteristic of esophageal cancer (EC) and esophageal-gastric junction cancer (EGJC) is the high
percent of metastatic disease at the time of diagnosis one of the main causes of death in these patients. The present
case is about a 78-year-old man, diagnosed with Barrett's esophagus with high-grade dysplasia and stenosis of distal
third of esophagus, during surgery we found peritoneal carcinomatosis with implants in gut and no resectably disease.
Keywords: EC, Peritoneal carcinomatosis, Surgery, Surgical oncology
1
General Surgery Department, North Central Hospital, PEMEX. Mexico City, Mexico
2
General Surgery Department, Monterrey Regional Hospital, ISSSTE, Monterrey City, Mexico
3
Medicine Faculty of Guerrero University of Medicine, Acapulco City, Mexico
4
General Surgery Department, General Zone Hospital Number 33, IMSS, Monterrey City, Mexico
5
General Surgery Department, Minatitlan Regional Hospital PEMEX, Veracruz, Mexico
Received: 17 December 2022
Accepted: 08 January 2023
*Correspondence:
Dr. Ludwigvan A. Bustamante S.,
E-mail: Lbustamantes1994@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20230270