A Case of Esophageal Adenocarcinoma Metastasized to the Scalp

Abstract

Cutaneous metastases from internal malignancies are, occurring in 0.5% to 9% of cases. Lung, breast, and colorectal cancers are common primary tumors that metastasize to the skin; cutaneous metastasis usually occurs on the chest wall and abdomen as asymptomatic nodular patterns. Esophageal cancer is not nearly as common as breast, lung, and colorectal cancers, and esophageal cancer rarely metastasizes to the skin. Cutaneous metastasis of esophageal cancer is rare and metastasis to the scalp is extremely rare. Only a few cases of cutaneous metastases of esophageal cancer have been reported in Korea. Most of the cases involved cutaneous metastases arising from esophageal squamous cell carcinoma; however, there have been several reports describing cutaneous metastases from esophageal adenocarcinomas. Herein, we describe a case of metastatic skin cancer that originated from esophageal adenocarcinoma. (Ann Dermatol 21(2) 164∼167, 2009)

Cutaneous Metastases From Esophageal Adenocarcinoma

“…2,14 According to literature, the average time of occurrence of the metastatic disease was estimated to be approximately 2.9 years after the onset of the primary tumor. 1 Esophageal adenocarcinoma may metastasize to various tissues of the human body. Most frequently esophageal adenocarcinoma metastasizes to the liver, lungs, and brain.…”

“…More precisely, most of the primary tumors that develop at or near the gastroesophageal junction arise from Barrett's esophagus, as a complication of chronic gastroesophageal reflux disease. 1,14 Although in Western countries, the squamous cell carcinoma used to be the most common type of cancer, nowadays it is the adenocarcinoma that appears to be the most frequent one. 16 Histopathologic report of the biopsies obtained from the esophagus should be taken under consideration as it has been observed that the tumor subtype is a strongly connected to the survival rate factor.…”

“…In comparison to the squamous cell carcinoma, it has been proven that the adenocarcinoma subtype is a longer survival rate factor. 1 Given the fact that the patient in case 2 underwent a CT and a PET during the preoperative staging and that both diagnostic methods were negative as they showed no distant metastases, the sensitivity of these methods seems to be limited. Recent achievements in revealing primary tumors include immunohistochemical stains capable of detecting antigens of malignancies via the utilization of labeled antibodies.…”

“…They consist of 0.5 to 9% of metastatic tumors in total. 1,2 Primary tumors that metastasize to the skin are in descending order of frequency, lung, breast, and rectal cancer. Metastases from esophageal malignancy to the skin are considered to be even rarer.…”

“…5 The skin lesions may be observed in different locations of the human body. 2,[6][7][8][9][10][11][12][13] We describe 2 cases of cutaneous metastases in patients diagnosed with esophageal adenocarcinoma.…”