Esophageal metastasis of renal cell carcinoma resected by endoscopic submucosal dissection: a case report

Abstract

Background Esophageal metastasis of renal cell carcinoma (RCC) is extremely rare. We have described herein a case of a 59-year-old man with esophageal metastasis of RCC that was endoscopically resected. Case presentation The case was a 59-year-old man who had undergone left nephrectomy for renal clear cell carcinoma 17 years ago and splenectomy for splenic metastasis 3 years ago. Esophagogastroduodenoscopy (EGD) performed 9 years ago revealed a small reddish elevated lesion with a smooth surface in the middle esophagus; this lesion increased in size 4 years ago. However, no biopsy was performed. The lesion continued to grow in size and was found to have become nodular during the present observation. Biopsy revealed clear cell carcinoma. Endoscopic ultrasound (EUS) revealed that the lesion had not invaded the submucosa, and contrast-enhanced computed tomography did not reveal any other metastasis. The lesion was successfully removed en bloc via endoscopic submucosal dissection (ESD). Pathologically, the tumor was detected in the subepithelium with focal infiltration of the muscularis mucosa. It consisted of monotonous cells with small nuclei and a clear cytoplasm. Immunohistological findings indicated that the tumor was a metastasis of RCC. The lateral and vertical margins were noted to be free. Conclusions We have presented herein a case of esophageal metastasis of RCC that had progressed over 9 years and was then resected en bloc through endoscopic submucosal dissection.

Early Metastasis of Clear Cell Renal Cell Carcinoma to the Esophagus: A Case Report

“…The time to metastatic relapse is variable, usually several years after surgical treatment. Our case report has an early filing of 4 months, which is below the average (24 months) in a series of cases [1] and for other case reports [2,[7][8][9], also the initial size of the mass is unusual with a commitment of 100% of the lumen, which is greater than the reported cases, where a solitary nodule or polyp is generally reported that does not occupy the entire esophageal diameter [2,9,10], the treatment is multidisciplinary, with surgical treatment as the first option and a combination of radiotherapy and chemotherapy [8,9], with the increasingly widespread use of tyrosine kinase inhibitors such as pazopanib [2][3][4][5][6], or checkpoint inhibitors.…”

“…Esophageal metastases from CCRC of clear cell variants are even rarer. Seven cases have been described in the literature, including our case report, which are shown in Table 1 [ 1 , 2 , 6 - 10 ]. Esophageal metastasis of RCC is extremely rare and there is not clear evidence why they appear.…”

“…Metastatic involvement in the esophagus is a very rare finding, in most cases, it is caused by the invasion of adjacent neoplasms of other tissues such as the lung, trachea, and thyroid some metastasis in the esophagus through the hematogenous route occurs mainly from the liver and uterus tumors [ 1 ]. Neoplasms in the esophagus cause clinical symptoms such as dysphagia and melena, and for the study of the symptomatology of dysphagia the endoscopy of the upper digestive tract is one of the most important tools for diagnosis since metastases manifest as polypoid lesions or ulcerative lesions that extend beyond the submucosa [ 2 ].…”

Endoscopic ultrasound-guided fine needle aspiration for smooth benign appearing malignant esophageal stricture: a cross-sectional study

“…Metastatic esophageal cancer is very rare clinically. Since the first case of metastatic esophageal cancer from the prostate was reported by Gross et al (16) in 1942, various metastatic esophageal cancers in different organs have been reported, including the breast, lungs, ovary, liver, colon, pancreas, bladder, kidneys, and stomach (17)(18)(19)(20)(21)(22)(23)(24)(25). The most common primary sites for metastatic esophageal cancer are the breast and lungs (17,18).…”

Efficacy of Digestive Endoscope Based on Artificial Intelligence System in Diagnosing Early Esophageal Carcinoma

“…According to epidemiological survey data, the incidence of esophageal carcinoma ranks eighth among all malignant tumors worldwide [ 3 ], the incidence in East Asia has been consistently higher than the world average due to the special dietary habits, and in China in 2018, new cases and deaths of esophageal carcinoma accounted for 53.7% and 55.7% of the global total, respectively, with esophageal carcinoma burden about two times the world level [ 4 , 5 ]. Early diagnosis and treatment is key to reducing such burden in China [ 6 , 7 ]. Currently, endoscopy, a set of devices for the diagnosis and treatment of digestive diseases by direct acquisition of images of the alimentary tract and digestive organs through the alimentary tract, has become a main method for diagnosis of early esophageal carcinoma in practice.…”