Successful treatment of recurrent esophageal squamous cell carcinoma with muscle metastasis using capecitabine and cetuximab.

Esophageal cancer (EC) is a relatively rare malignancy in the United States, although it is associated with high morbidity and mortality. More than 90% of EC cancer-related mortality is due to distant metastasis, most commonly to the liver, lungs, bone, and brain. Although EC has a high tendency for random dissemination, it rarely metastasizes to the muscles and soft tissue. Here, we report a rare case of a patient with recurrent esophageal squamous cell carcinoma metastasis to his left thigh musculature, initially suspected to be a soft tissue sarcoma on magnetic resonance imaging. The patient did not tolerate standard chemotherapy with epirubicin, oxaliplatin, and capecitabine and was subsequently successfully treated with neoadjuvant radiotherapy, surgery, and adjuvant chemotherapy with capecitabine and cetuximab for 2 years and capecitabine alone for 1 year.