Ricerc@Sapienza

Introduction: Adenocarcinoma of the cardia synchronous with other intraabdominal neoplasms is very rare. We
report the case of a Siewert type II adenocarcinoma of the cardia synchronous with an adenocarcinoma of the
sigmoid both treated simultaneously by transjatal oesophago-gastrectomy and anterior resection of the sigmoid.
Case report: A 62 year-old male was admitted for a progressing dysphagia and weight loss. Oesophago-gastric
fibroscopy detected an adenocarcinoma of the cardia extending to the distal 2 cm of the esophagus (Siewert
typeII). A CT-scan of the chest and abdomen confirmed the cancer of the cardia and also decealed a synchronous
tumor of the sigmoid. Both neoplasms were resected through a xipho-pubic laparotomy, with an ileostomy
completing the procedure. Postoperative course was uneventful and ileostomy was closed four weeks later. The
patient was subsequently addressed to oncological for adjuvant treatment.
Discussion: This report supports the indication of aggressive, simultaneous treatment of an adenocarcinoma of
the cardia associated with a synchronous abdominal neoplasm, provided that both are resectable through the
same surgical access, as anticipated at a preoperative, through diagnostic work-up.
Conclusion: Simultaneous resection of synchronous adenocarcinoma of the cardia and the sigmoid is feasible and
avoids possible progression of the untreated neoplasm during the interval between two separate resections,
provided that a curative resection can be obtained for both diseases.