The development of an invasive adenocarcinoma arising from gastric muc
osa within the neo-esophagus of a Collis gastroplasty is uncommon. We
report 1 patient in whom an adenocarcinoma developed 18 years postoper
atively, and who was treated by total gastrectomy. We suggest accurate
preoperative evaluation and staging to distinguish tumors arising in
the distal esophagus from those arising in the gastric mucosa of the n
eo-esophagus, and recommend an approach to management of these tumors.