Background: Metastasis to the esophagus is a rare event that can occur by direct infiltration of malignancies from nearby organs or, more infrequently, via lymphatic or hematogenous spread. Methods: We reviewed the hospital charts of a patient presenting with dysphagia in whom a distant metastasis to the esophagus from a primary lung adenocarcinoma was documented. A review of the pertinent literature was performed. Results: A 74 year-old man with previous history of lung cancer and transoral septum stapling for Zenker’s diverticulum presented with subtotal dysphagia and chest pain. On upper gastrointestinal endoscopy, a vegetating mass of the middle esophagus, covered by fragile and bleeding mucosa, was found. Esophageal biopsies demonstrated metastasis from a poorly differentiated lung adenocarcinoma with evidence of thyroid transcription factor (TTF) positive neoplastic cells. A computed tomography scan revealed a radiopaque mass in the upper right lung. Combination chemotherapy was initiated and a partially covered stent was placed endoscopically. Conclusions: A distant metastatic tumor to the esophagus with mucosal infiltration is an exceptional event. In our patient, immunohistochemistry was useful to confirm the diagnosis of primary lung carcinoma.

Metastasis to the esophagus from primary adenocarcinoma of the lung / S. Zanghi, S. Siboni, E. Asti, A. Festa, L. Bonavina. - In: EUROPEAN SURGERY. - ISSN 1682-8631. - 50:1(2018), pp. 30-32. [10.1007/s10353-017-0501-1]

Metastasis to the esophagus from primary adenocarcinoma of the lung

S. Siboni;E. Asti;L. Bonavina
2018

Abstract

Background: Metastasis to the esophagus is a rare event that can occur by direct infiltration of malignancies from nearby organs or, more infrequently, via lymphatic or hematogenous spread. Methods: We reviewed the hospital charts of a patient presenting with dysphagia in whom a distant metastasis to the esophagus from a primary lung adenocarcinoma was documented. A review of the pertinent literature was performed. Results: A 74 year-old man with previous history of lung cancer and transoral septum stapling for Zenker’s diverticulum presented with subtotal dysphagia and chest pain. On upper gastrointestinal endoscopy, a vegetating mass of the middle esophagus, covered by fragile and bleeding mucosa, was found. Esophageal biopsies demonstrated metastasis from a poorly differentiated lung adenocarcinoma with evidence of thyroid transcription factor (TTF) positive neoplastic cells. A computed tomography scan revealed a radiopaque mass in the upper right lung. Combination chemotherapy was initiated and a partially covered stent was placed endoscopically. Conclusions: A distant metastatic tumor to the esophagus with mucosal infiltration is an exceptional event. In our patient, immunohistochemistry was useful to confirm the diagnosis of primary lung carcinoma.
Distant metastasis; Dysphagia; Esophageal carcinoma; Esophagus; Lung adenocarcinoma
Settore MED/18 - Chirurgia Generale
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/811592
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