Esophagogastric adenocarcinoma

Abstract

Introduction: The adenocarcinoma of esophagogastric junction includes three anatomical entities which have in common parietal extension and lymphatic dissemination both to the mediastinum and abdomen. Due to the dramatically increasing incidence, Siewert & Stein described and classified the disease as a tumor located 5 cm above and under the anatomical cardia, in order to lead to an optimal surgical treatment. Clinical case: A 71 years old male presented to C.F. Cluj- Napoca Hospital complaining about progressive dysphagia, loss of appetite, postprandial regurgitation with fetid halitosis. In association, the patient presented fatigability and weight loss (4-5 kg in the last 3 months). The patient history reveals the existence of multiple cardiac pathology, such as atrial fibrillation, atrioventricular block grade III, right bundle branch block, aortic regurgitation grade II and mitral regurgitation grade II. The results of the paraclinical tests lead us to the following diagnosis: adenocarcinoma of esophagogastric junction type II Siewert- Stein, pT4N1M1. Taking into account the cardiac pathology, the optimal treatment in this case is a gastrostomy. Conclusion: The particularity of the case consists in choosing the most appropriate surgical therapy considering the advanced stage of the tumor and the Associated comorbidities.