1. Clinical Case….. ULB - Hôpital Erasme
Clinic of Upper Gastro Intestinal Tract Surgery
Department of Digestive Surgery
Eleonora Farinella

2. History: January 2014 Clinical Presentation: Vomiting
Dysphagia for solid foods
Weight loss -10kg
Anaemia

3. ADENOCARCINOMA CARDIA SIEWERT II
Diagnostics:
April 2014
Esophago-gastroscopy:
Tumor of the cardia
Extension: >39 cm and <46 cm
Tumor centre: 42 cm
Biopsy: Well-differentiated adenocarcinoma
ADENOCARCINOMA CARDIA SIEWERT II

4. ESOPHAGEAL SCANNER (16/04/14):
Tumor staging(1):
ESOPHAGEAL SCANNER (16/04/14):
Thickening of the lower esophagus and the lesser curvature of the stomach.
Locoregional adenopathy: mediastinum and perigastric
No liver or lung metastasis
c T4 N+ M0, SIEWERT II

5. Tumor staging(2): PET/CT (18/04/14):
Hyper metabolic lesion of the cardia
Metastatic lymphadenopathy of lesser curvature

6. ENDOSCOPIC ULTRASOUND (14/4/14):
Tumor staging(3):
ENDOSCOPIC ULTRASOUND (14/4/14):
Stenosis lesion of cardia.
Tumor-infiltrating the cardia, pleura and diaphragmatic pillars.
Locoregional adenopathy peri cardial
u T4 N +, SIEWERT II
GASTROESOPHAGEAL TRANSIT (15/04/14):
Large sub-cardial ulceration.
The whole stomach is the seat of a parietal malignant infiltration.

7. Option (s) treatment (s)?
Primary surgery
Neoadjuvant chemotherapy
Neoadjuvant chemoradiotherapy
Definitive chemoradiation
Palliative treatment

8. …curious about the evolution?
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