Unusual metastasis of esophageal cancer

Vladimir Vidovic, Ivan Nikolic, Jelena Vukojevic, Golub Samardzija, Biljana Kukic, Bogdan Bogdanovic, Nemanja Petrovic
2014 Vojnosanitetski Pregled  
Introduction. Carcinoma of the esophagus is in the eighth place by the frequency of malignant diseases and the sixth cause of death from cancer worldwide. It usually metastasizes to regional lymph nodes, liver, lungs, central nervous system, and bones, but metastases can appear to unusual locations such as facial skin and lips. Case report. We presented a 56year-old man who reported to his physician because of upper lip swelling. A physical checkup of the patients also showed a lesion on the
more » ... a lesion on the skin of the left temporal region and both lesions were biopsied. Based on the results of histopathological and immunohistochemical analyses of the samples a diagnosis of metastatic adenocarcinoma to the skin was established. Additional diagnostic procedures, including esophagogastroduodenoscopy, detected the infiltration into the distal part of esophagus, which was histopathologically confirmed as adenocarcinoma of esophagus. The results of positron emission tomography/computed tomography (PET/CT) examination showed the invasion of the disease. Because of the disease expansion, a multidisciplinary oncology team suggested chemo-and radiotherapy treatment. The patient has received 4 cycles of platinum-based chemotherapy so far. Conclusion. The physicians should always consider unusual skin lesions as the first sign of cancer spreading. Uvod. Karcinom jednjaka je osmi karcinom po u estalosti i šesti uzrok smrti od karcinoma u svetu. Naj eš e metastazira u regionalne limfne vorove, jetru, plu a, centralni nervni sistem, kosti, ali se sre u metastaze i na neuobi ajenim mestima kao što su koža lica i usne. Prikaz bolesnika. Prikazali smo bolesnika starog 56 godina koji se javio lekaru zbog otekline u predelu gornje usne. Pregledom je vi ena i promena u predelu kože slepoonog predela glave sa leve strane te su u istom aktu ekstirpirane obe promene. Patohistološkim pregledom, ukljuuju i imunohistohemijsku analizu, postavljena je dijagnoza metastatskog adenokarcinoma u koži. Dopunskom dijagnostikom, uklju uju i ezofagogastroduodenoskopiju vi ena je infiltracija distalnog dela jednjaka, iji je patohistološki nalaz potvrdio dijagnozu adenokarcinoma jednjaka. Pozitronska emisiona tomografija-kompjuterizovana tomografija (PET/CT) je ukazala na proširenost bolesti. S obzirom na proširenost bolesti multidisciplinarni onkološki tim je predložio hemioterapiju i radioterapiju. Bolesnik je do sada primio etiri serije hemioterapije po protokolu sa platinom. Zaklju ak. Lekari moraju imati na umu da neuobi ajene promene na koži mogu biti prvi znak proširenosti karcinoma. Klju ne re i: jednjak, neoplazme; neoplazme, metastaze; usna; dijagnoza; adenokarcinom; histološke tehnike; imunohistohemija.
doi:10.2298/vsp1410975v pmid:25518280 fatcat:7uqz4lzkobgvxon7v3ibudctem