Ludmir Ethan B, Robey Benjamin, Shelby Evan, Patel-Nguyen Sonya V, Rittershaus Ahren, Contarino Michael R
Department of Internal Medicine, University of North Carolina, Chapel Hill, NC, USA.
Department of Pathology, WakeMed Hospitals, Raleigh, NC, USA.
Transl Gastroenterol Hepatol. 2016 May 4;1:37. doi: 10.21037/tgh.2016.04.05. eCollection 2016.
Symptomatic skeletal muscle metastasis from esophageal adenocarcinoma is rare. Here we report the case of a 49-year-old man who presented with right thigh pain, and was found to have symptomatic psoas muscle metastasis as the presentation of esophageal adenocarcinoma. The primary tumor was notable for signet ring cells (SRC), a poor prognostic indicator as well as a predictor of biologic aggressiveness. The patient passed away within 1 month of diagnosis due to disease progression, supporting the aggressiveness of such SRC esophageal lesions. Lastly, a literature review reveals a differential pattern of metastatic spread between esophageal adenocarcinomas and squamous cell carcinomas as regards muscle metastases. Skeletal muscle metastases are more likely to be due to esophageal adenocarcinoma, whereas myocardial metastases are almost exclusively due to esophageal squamous cell carcinoma (ESCC). These differences may represent an example of the 'seed and soil' hypothesis of metastasis.
食管腺癌出现有症状的骨骼肌转移较为罕见。在此，我们报告一例49岁男性病例，该患者因右大腿疼痛就诊，被发现患有有症状的腰大肌转移，这是食管腺癌的一种表现形式。原发肿瘤以印戒细胞（SRC）为特征，这是一种预后不良指标，也是生物学侵袭性的预测指标。该患者在诊断后1个月内由于疾病进展而死亡，这支持了此类SRC食管病变的侵袭性。最后，文献综述揭示了食管腺癌和鳞状细胞癌在肌肉转移方面转移扩散的差异模式。骨骼肌转移更可能由食管腺癌引起，而心肌转移几乎仅由食管鳞状细胞癌（ESCC）引起。这些差异可能是转移“种子与土壤”假说的一个例证。
