What happened, in summary

A 64-year-old man developed more than a month of difficulty eating. Endoscopy showed two dark masses in the esophagus and a separate ulcer in the lower stomach. Gastric biopsy revealed poorly differentiated mucinous adenocarcinoma. Further evaluation supported two distinct primary cancers rather than one tumor spreading into the other organ.

He underwent a major combined operation that included radical gastric cancer surgery, esophageal resection and reconstruction using the colon. Pathology of the stomach confirmed poorly differentiated mucinous adenocarcinoma with signet-ring cells invading the superficial muscular layer. No gastric lymph-node metastases were found. The gastric cancer was classified as Stage I. The esophageal tumors were confirmed as primary malignant melanoma.

He recovered from surgery, began taking small amounts of liquid food after 2 weeks and was discharged in good condition after 3 weeks. No postoperative chemotherapy or radiation was given.

Despite the apparently localized gastric cancer, the overall situation was complicated by the simultaneous esophageal melanoma. He died 3 months after the combined operation. The gastric and esophageal cancers were separate primary tumors with different pathology and disease courses.