Vidović Vladimir, Nikolić Ivan, Vukojević Jelena, Samardžija Golub, Kukić Biljana, Bogdanović Bogdan, Petrović Nemanja
Vojnosanit Pregl. 2014 Oct;71(10):975-7.
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.
We presented a 56- year-old man who reported to his physician because of upper lip swelling. A physical checkup of the patients also showed 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.
The physicians should always consider unusual skin lesions as the first sign of cancer spreading.
食管癌在全球恶性疾病发病率中位列第八,是癌症死亡的第六大原因。它通常转移至区域淋巴结、肝脏、肺、中枢神经系统和骨骼,但转移也可能出现在不寻常的部位,如面部皮肤和嘴唇。
我们介绍了一名56岁男性,因上唇肿胀就医。对该患者进行体格检查时,还发现左侧颞部皮肤有一处病变,两处病变均进行了活检。根据样本的组织病理学和免疫组化分析结果,确诊为皮肤转移性腺癌。包括食管胃十二指肠镜检查在内的其他诊断程序发现食管远端有浸润,组织病理学证实为食管腺癌。正电子发射断层扫描/计算机断层扫描(PET/CT)检查结果显示了疾病的侵袭情况。由于疾病进展,多学科肿瘤团队建议进行化疗和放疗。该患者目前已接受了4个周期的铂类化疗。
医生应始终将不寻常的皮肤病变视为癌症扩散的首要迹象。