Uncommon Cancers of the Esophagus

Imaging of uncommon esophageal malignancies

“…There are three possible distinct mechanisms of secondary involvement of esophagus by nonesophageal malignancies . The most common mechanism is direct extension of malignant neoplasms of the hypopharynx, larynx, tracheobronchial tree, lung, stomach and mediastinal nodes . Direct esophageal involvement by these cancers usually indicates advanced stage necessitating palliative therapies like esophageal stenting.…”

“…The other mechanisms of secondary esophageal involvement are through lymphogenous or hematogenous spread from distant primaries. Metastases to the esophagus are uncommon with an incidence of 3–6% in autopsy studies of patients dying of any cancers . Gross and Freedman described the first case of esophageal metastasis in a patient with prostate cancer in 1942 .…”

“…In more advanced stages, there can be transmural infiltration of the esophageal wall with intraluminal soft tissue casing esophageal obstruction. Metastasis to esophagus from distant primaries is often submucosal in location and has tendency to involve the mid or lower esophagus . Presence of intact over lying mucosa often makes endoscopic diagnosis difficult.…”

“…The management of esophageal metastases involves endoscopic dilatation with esophageal stenting which is associated with high risk of perforation (Fig. ) . Alternative treatment options include chemotherapy, brachytherapy, external beam radiotherapy and surgical resection or bypass …”

“…43 The most common mechanism is direct extension of malignant neoplasms of the hypopharynx, larynx, tracheobronchial tree, lung, stomach and mediastinal nodes. 44 Direct esophageal involvement by these cancers usually indicates advanced stage necessitating palliative therapies like esophageal stenting. The other mechanisms of secondary esophageal involvement are through lymphogenous or hematogenous spread from distant primaries.…”