Metastatic Esophageal Tumor from Cecal Carcinoma

Abstract

A 55-year-old man developed progressive dysphagia 14 months after palliative colectomy and subsequent systemic chemotherapy for advanced cecal cancer with carcinomatosis peritonei. Radiologic and endoscopic examinations suggested a submucosal tumor in the lower esophagus causing a severe luminal stricture. A self-expanding metal stent was placed for palliation. The prosthesis was effective for several months, but ingrowth of the tumor caused re-stricture of the esophagus. Since his general condition was quite good without any evidence of recurrence of the cecal cancer, we performed bypass surgery for palliation. The pathological appearance of the tumor was compatible with the metastasis of cecal cancer. Our case suggests that a surgical approach can be considered as a therapeutic method for metastatic esophageal tumor, even in patients with advanced cancer, as long as the primary tumor is satisfactorily controlled.

Inguinal lymphadenopathy secondary to adenocarcinoma of caecum: A case report

“…Caecal adenocarcinoma has been shown previously to metastasise to some unusual sites like retina [4], chin [5], cervical node [6], subcutaneous tissue [7], breast [8], oesophagus [9], spleen [10], pancreas [11], umbilicus [12], urinary bladder [13], uterus [14], vagina [15], penis [16], spermatic cord [17] and epididymis [18]. Tumors that usually metastasise to inguinal lymph nodes are malignant lymphomas and squamous cell carcinoma of vulva, penis and anus.…”

Esophageal Metastasis from Rectal Cancer Successfully Treated with Fluorouracil-Based Chemotherapy with Bevacizumab: A Case Report and Review of the Literature

“…Autopsy studies have shown that 3.1–6.1% of patients dying from any cancer type exhibited esophageal metastasis, with breast and lung cancer representing the most common primary sites [9, 10]. To date, secondary involvement of the esophagus by colorectal cancer has been reported in five cases [4, 5, 6, 7, 8] (Table 1). Most of those patients underwent initial surgery and relapsed with new metastatic lesions in the esophagus, suggesting a unique clinical feature of the esophageal metastasis from colorectal cancer.…”

“…As one of the modes of esophageal metastasis, vascular or lymphatic spread from distant primary sites has been proposed [2]. Hematogenous spread of cecal carcinoma cells has been noted in a case of esophageal metastasis, showing lack of mediastinal lymph node involvement [6]. It has also been suggested that an abundant lymphocapillary network in the submucosal layer of the esophagus enabled tumor cells from the mediastinal lymph nodes to penetrate the esophagus wall vertically or transversely, which resulted in the lymphatic spread of primary tumor [12].…”

“…Treatment options for colorectal cancer patients with esophageal metastasis include endoscopic stent, bypass surgery [6], chemotherapy [6, 7, 8], and palliation [5]; however, unfavorable outcomes are common due to the extensive progression of the primary cancer. In the present case, rapid tumor progress with pulmonary lymphangitic carcinomatosis necessitated prompt initiation of systemic chemotherapy for the recurrence.…”

“…In patients with metastatic colorectal carcinoma, chemotherapy using targeted agents increased median survival times to more than 30 months [3]. In contrast, the outcome of patients with esophageal metastasis remains poor, despite various treatment options [4, 5, 6, 7, 8]. We describe a case of postoperative recurrence of rectal cancer with esophageal metastasis, in which a repeated endoscopic biopsy with immunohistochemical assessment was diagnostic, and the combination of fluorouracil-based chemotherapy and bevacizumab showed a durable tumor response and tolerability.…”