A squamous cell carcinoma of the gastric cardia showing submucosal progression

We report a case of squamous cell carcinoma (SCC) of the gastric cardia sho wing submucosal progression with direct invasion of the liver. 4 71-year-ol d man was admitted with dysphagia. Esophagogastroscopy showed a protruding tumor covered with normal gastric mucosa in the anterior wall of the gastri c cardia, although no abnormal findings were detected in the esophagus, inc luding the esophagogastric junction. Serum SCC-related antigen level was el evated (6.6 ng/ml; normal level, less than 2.5 ng/ml). Endoscopic biopsy sp ecimens taken from this tumor did not show malignant cells. Based on these findings, the preoperative diagnosis was a submucosal turner of the stomach . Laparotomy was done; however, the tumor was not resected because it had d irect invasion to the left lateral segment of the liver and adjacent tissue s. As the tumor showed continuous bleeding from the stomach after surgery, total gastrectomy, combined with transhiatal lower esophagectomy, left late ral segmentectomy of the liver, splenectomy, and distal pancreatectomy was performed. Because histologic findings showed poorly or moderately differen tiated SCC with direct invasion of the liver, the final diagnosis was SCC o f the gastric cardia showing submucosal progression with hepatic invasion. Such a case of SCC of the gastric cardia showing submucosal progression is rare, and accurate preoperative diagnosis was very difficult. However, it m ay be important to consider SCC of the gastric cardia in such a situation.