Total Gastrectomy, Lower Esophagectomy, and Descending Aorta Replacement in a Patient with Gastric Cancer and Thrombus in the Descending Aorta

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 9; pp. 2438 - 2441
• Main Authors: ISHIBASHI, Yuji, MAZAKI, Junichi, SAITO, Hiroyuki, OMORI, Keita, WAKABAYASHI, Kazuhiko, ITO, Yutaka
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2014
• Subjects: aorta thrombus; descending aorta replacement; gastric cancer
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.2438

A 66-year-old woman diagnosed as having gastric cancer was referred to our hospital with the complaint of dysphagia. Fiberoptic gastrointestinal endoscopy showed a tumor in the cardia and lower esophagus. Abdominal CT revealed thickening of the wall of the upper part of the gastric corpus. Furthermore, a 2-cm long mass was visualized along the lumen of the descending aorta. We diagnosed the patient as having gastric cancer invading the lower esophagus with a thrombus in the descending aorta. She had already begun to experience difficulty in swallowing and was at a high risk of embolism. Therefore, an operation as soon as possible was considered to be necessary to treat both the diseases, and total gastrectomy, lower esophagectomy, and descending aorta replacement by a left thoracoabdominal approach were performed. During the subsequent 6 months' follow-up, the patient has shown no evidence of a recurrent thrombus in the aorta or embolic events, or any evidence of metastasis from the gastric cancer.