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March 1960

Carcinoma of the Esophagus with Metastases to the Base of an Active Peptic Ulcer

Author Affiliations

New York
From the Department of Surgery, College of Physicians and Surgeons, Columbia University, The Presbyterian Hospital, and the Francis Delafield Hospital.

AMA Arch Surg. 1960;80(3):438-441. doi:10.1001/archsurg.1960.01290200082013

The infradiaphragmatic spread of carcinoma of the lower esophagus is a wellknown phenomenon. Rouvière11 describes the regional collecting lymphatic trunks of the distal third of the esophagus as descending toward the abdominal cavity. In studying large numbers of autopsy specimens of carcinoma of the esophagus, Dormanns3 reported that in 285 cases with lower-third esophageal carcinoma, 121 (42%) exhibited metastases to the abdominal lymph nodes. In this country Churchill and Sweet1 reported subdiaphragmatic lymph node metastases in 8 of 16 patients with lower-third esophageal carcinoma.

The spread of esophageal carcinoma to the stomach itself is believed by Willis16 to be due to lymphatic permeation. Kaufmann,6 in discussing secondary carcinomas of the stomach, states: "Secondary carcinomas occur most frequently by continuity from the esophagus and are of the squamous cell type. The mode of spread is via the submucous, the subserous lymphatics, or both; in the first

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