Shimada Yutaka, Okumura Tomoyuki, Hojo Shozo, Sukegawa Kenta, Nagata Takuya, Hayashi Shinichi, Tsukada Kazuhiro
Department of Surgery and Science, Graduate School of Medicine & Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan Department of Nanobaio Drug Discovery, Graduate school of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
Department of Surgery and Science, Graduate School of Medicine & Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
J Surg Case Rep. 2014 Jan 7;2014(1). doi: 10.1093/jscr/rjt117. Print 2014 Jan.
The management of synchronous asymptomatic colonic metastases from primary esophageal squamous cell carcinoma (ESCC) has not yet been reported. A 64-year-old male patient was diagnosed with middle thoracic ESCC. The patient received chemoradiotherapy and incomplete response/stable disease was achieved. Preoperative colonoscopy revealed a 1.0-cm submucosal tumor at the splenic flexure of the colon, and biopsy results indicated possible metastasis from primary ESCC. The patient underwent subtotal esophagectomy and the colonic tumor was excised. A postoperative pathological diagnosis confirmed that the colonic tumor had metastasized from primary ESCC. Even though the patient was discharged 18 days after surgery without any complications, he died on the 72nd postoperative day due to multiple bone metastases and pleural dissemination. Our findings suggest that even with well-controlled and asymptomatic colonic metastasis from primary esophageal lesions, the prognosis of patients with primary ESCC is poor.
原发性食管鳞状细胞癌（ESCC）同步无症状性结肠转移的管理尚未见报道。一名64岁男性患者被诊断为胸段中段ESCC。患者接受了放化疗，达到部分缓解/疾病稳定。术前结肠镜检查发现结肠脾曲有一个1.0厘米的黏膜下肿瘤，活检结果提示可能为原发性ESCC转移。患者接受了食管次全切除术，并切除了结肠肿瘤。术后病理诊断证实结肠肿瘤已从原发性ESCC转移。尽管患者术后18天无任何并发症出院，但术后第72天因多发骨转移和胸膜播散死亡。我们的研究结果表明，即使原发性食管病变的结肠转移得到良好控制且无症状，原发性ESCC患者的预后也很差。
