Metastatic squamous cell carcinoma of colon from esophageal cancer

Abstract

BackgroundEsophageal cancer including squamous cell carcinoma (SCC) and adenocarcinoma represents 4% of all cancers in the United States. Patients with esophageal cancer frequently present with locally advanced disease, and about 40% of patients have evidence of metastatic disease on presentation. Common sites of metastasis include liver, lung and bone. Here, we present a rare case of colonic metastasis from primary esophageal SCC.Case presentationA 60-year-old Caucasian male with a history of 20-pack-year cigarette smoking received surgery and adjuvant chemoradiotherapy for locally advanced SCC of larynx. Approximately 9 months later, he developed dysphagia, and found to have a esophageal SCC in the mid-esophagus with regional lymph node involvement. He underwent chemoradiation treatment with good response and improved symptoms but declined subsequent surgical resection for esophageal cancer. About 1 year after the diagnosis of esophageal cancer, he developed blood streaked bowel movement and severe anemia. Colonoscopy showed a 3-cm mass in the proximal ascending colon; biopsy showed metastatic SCC, consistent with metastasis from esophageal primary. He subsequently received palliative radiation to the ascending colon metastatic tumor with improvement of anemia, and remained transfusion independent for more than 3 months.ConclusionsColonic metastasis from esophageal SCC is rare, and associated with poor prognosis. There are no definite features in terms of location, histological differentiation etc. that contribute to colonic metastasis from primary esophageal SCC. The goal of treatment is palliative and data from our and other case reports support the use of chemotherapy and radiation for symptom improvement and disease control.

A Case of Esophageal Squamous Cell Carcinoma Metastasized to the Colonic Anastomotic Site of Right Hemicolectomy

“…1 Although squamous cell carcinoma of the esophagus rarely metastasizes to the uncommon sites, 2 colonic metastasis from squamous cell carcinoma of the esophagus is extremely rare with 5 previous case reports. [3][4][5][6][7] There has been no case report of colonic metastasis from squamous cell carcinoma of the esophagus to the anastomotic site of previous right hemicolectomy. We report the first case of colonic metastasis from squamous cell carcinoma of the esophagus to the anastomotic site of previous right hemicolectomy.…”

“…[3][4][5] Two cases affected the transverse colon, 2 cases affected the rectosigmoid colon, and 1 case affected the ascending colon. [3][4][5][6][7] All 4 patients except 1 patient with no follow-up information died of esophageal squamous cell carcinoma within 1 year from the diagnosis of colonic metastasis. Our patient presented with synchronous lesion at the anastomotic site in the transverse colon.…”

“…1 Although squamous cell carcinoma of the esophagus rarely metastasizes to the uncommon sites, 2 colonic metastasis from squamous cell carcinoma of the esophagus is extremely rare with 5 previous case reports. [3][4][5][6][7] To our knowledge, this is the first case report of colonic metastasis from squamous cell carcinoma of the esophagus to an anastomotic site of the colon.…”

Unusual Metastases of Esophageal Squamous Cell Carcinoma

“…2 Colonic metastasis from ESCC is extremely rare, and only a few cases had mentioned this condition. [3][4][5][6][7][8] Peritoneal metastasis is also uncommon for patients with ESCC and accounts for 16% of metastasis. 9 Distant metastasis has a critical role on cancer-related deaths in patients with ESCC, and lower overall survival rate, usually 10 months, is reported in these patients with rare metastatic sites.…”

“…The most common sites of distant metastasis from ESCC are liver, lung, bones, and brain, 1 and uncommon metastatic sites have been reported in skin, eye, muscle, heart, and skull 2 . Colonic metastasis from ESCC is extremely rare, and only a few cases had mentioned this condition 3–8 . Peritoneal metastasis is also uncommon for patients with ESCC and accounts for 16% of metastasis 9 .…”