A 73-year-old man presented with progressive dysphagia and weight loss. Endoscopy showed an ulceroproliferative lesion involving the gastroesophageal junction extending into the fundus and cardia of the stomach. A biopsy sample from the lesion showed moderately differentiated adeno- carcinoma. Positron emission tomography showed a gastroesophageal junction growth with no activity in the lymph nodes and no distant metastasis. He underwent to- tal gastrectomy with regional lymphadenectomy (D1 gas- trectomy) and intrathoracic esophagojejunostomy with Roux-en-Y jejunojejunal anastomosis.
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