Endo Fumitaka, Akiyama Yuji, Onishi Masazumi, Uesugi Noriyuki, Sugai Tamotsu, Sasaki Akira
Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
Department of Dermatology, Iwate Medical University School of Medicine, Iwate, Japan.
Int J Surg Case Rep. 2021 Mar;80:105621. doi: 10.1016/j.ijscr.2021.02.007. Epub 2021 Feb 5.
Basaloid squamous cell carcinoma (BSCC) of the esophagus is a relatively rare histologic variant of squamous cell carcinoma. Here, we reported a case of solitary cutaneous metastasis as the first symptom of esophageal BSCC and was successfully treated with multidisciplinary treatment.
A 67-year-old man visited a local hospital with symptoms of dysphagia and cutaneous nodules on his left shoulder. Fluorine-18 fluorodeoxyglucose positron emission tomography revealed hypermetabolic accumulations in the middle thoracic esophagus, right recurrent laryngeal nerve lymph node, and epidermis of the left shoulder. Esophagogastroscopy revealed an ulcerative and infiltrating type tumor in the middle thoracic esophagus. Based on histopathologic examination of the endoscopic biopsy and the resected cutaneous tumor, the patient was diagnosed as esophageal BSCC with cutaneous metastasis. The patient was treated with chemotherapy followed by chemoradiotherapy. The therapeutic effect was a complete response, which was sustained for 39 months.
Review of previous literature in the PubMed database revealed only been two case reports on cutaneous metastasis of BSCC. Advanced BSCC of the esophagus with distant metastasis has a poor prognosis. Therefore, in our case, future careful follow-up is required.
Esophageal BSCC with cutaneous metastasis can be successfully managed by multidisciplinary treatment, including local resection of the cutaneous metastasis, systemic chemotherapy, and chemoradiotherapy.
食管基底样鳞状细胞癌（BSCC）是鳞状细胞癌中一种相对罕见的组织学变体。在此，我们报告一例以孤立性皮肤转移为首发症状的食管BSCC病例，并通过多学科治疗成功治愈。
一名67岁男性因吞咽困难和左肩皮肤结节症状就诊于当地医院。氟-18氟脱氧葡萄糖正电子发射断层扫描显示中胸段食管、右喉返神经淋巴结及左肩表皮有高代谢聚集。食管胃镜检查显示中胸段食管有溃疡性浸润型肿瘤。基于内镜活检和切除的皮肤肿瘤的组织病理学检查，患者被诊断为食管BSCC伴皮肤转移。患者接受了化疗，随后进行了放化疗。治疗效果为完全缓解，持续39个月。
检索PubMed数据库中既往文献发现，仅有两篇关于BSCC皮肤转移的病例报告。伴有远处转移的晚期食管BSCC预后较差。因此，在我们的病例中，未来需要仔细随访。
食管BSCC伴皮肤转移可通过多学科治疗成功处理，包括皮肤转移灶的局部切除、全身化疗和放化疗。
