Primary gastric conduit cancer (GCC) is a known but rare occurrence post-esophagectomy with gastric reconstruction of the
esophagus. As improvements in post-esophagectomy treatment and surveillance have increased patient survival, GCC is becoming
more common, with a reported incidence of 0.2-3.5%. We present the case of a 76-year-old man with metachronous adenocarcinoma
of the gastric conduit antrum 10 years after Ivor-Lewis esophagectomy for esophageal adenocarcinoma. He was treated by a total
gastrectomy with colonic interposition for esophageal reconstruction.