Leptomeningeal metastasis from squamous cell carcinoma of oesophagus with unusual presentation

Abstract

SummaryOesophageal cancer rarely metastasis to the brain but advances in brain imaging and increasing survival of these patients has led to more detection of this condition. Although oesophageal cancer is common in the north of Iran it is less frequent in the central parts such as Yazd. Leptomeningeal metastasis is very uncommon in oesophageal cancer. This paper presents a 73-year-old man with leptomeningeal carcinomatosis from squamous cell carcinoma of oesophagus presented by hoarseness due to true vocal cord plegia. BACKGROUND

Leptomeningeal carcinomatosis from oesophageal cancer, presenting as meningitis

“…A review of previously reported cases revealed that age ranges from 39 to 68 years (mean, 44.1 years), and most cases involve males. The commonest symptoms are headache, vertigo,3 hearing loss,4 focal neurological deficit, spinal haematoma,5 lumbago, dysuria,6 seizure, vision loss7 and vocal cord paralysis 8. Squamous cell type was the commonest histological variant in previous case reports, but a recent series of seven cases revealed predominance of adenocarcinoma (77%) 9.…”

Multiple Meningocerebral Metastasis and Extensive Skull Metastasis from Squamous Cell Carcinoma of Esophagus: A Case Report and Review of Literature

“…It is well known that esophageal cancer may cause distant metastasis, most frequently in the lungs, pleura, liver, peritoneum, and the adrenal gland. However, metastasis to the bones is infrequent, and skull metastasis from esophageal cancer may be extremely rare [12]. Brain metastasis secondary to esophageal carcinoma is considered to be a rare event, with a reported incidence of between 0.5 and 4.8% [345].…”

“…Several studies in the United States also reported low incidence of brain metastasis in patients with esophageal cancer [51113]. Although some studies have reported esophageal cancer with brain metastasis [678], dural metastasis has been reported only 3 case in the past literature [129]. Akhavan and Navabii [1] reported a case of leptomeningeal carcinomatosis from squamous cell carcinoma of esophagus presented by hoarseness.…”

“…Esophageal carcinoma frequently metastasizes to the lungs and liver, but carcinoma of the esophagus has been considered an uncommon source of metastatic brain tumor [12]. Three studies from Japan reported the incidence of brain metastasis in patients diagnosed with esophageal cancer in the 1980s to early 2000s as ranging from 1.4–1.5% [34].…”

“…Several other studies reported that the incidence of brain metastasis in a contemporary series of patients with carcinoma of the esophagus ranged from 0.5% to 4.8% [345]. Although some studies have mentioned esophageal cancer with solitary brain metastasis [678] or with meningocerebral metastasis [129] or with skull metastasis [110], multiple meningocerebral metastasis and extensive skull metastasis from squamous cell carcinoma of esophagus has not been reported in the literature. We report a patient with an extensive osteolytic change of the skull and multiple meningocerebral metastases from esophageal carcinoma.…”