Sittitrai Pichit, Ruenmarkkaew Donyarat, Lekawanvijit Suree
Department of Otolaryngology.
Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Ann Med Surg (Lond). 2023 Jul 15;85(9):4603-4607. doi: 10.1097/MS9.0000000000001086. eCollection 2023 Sep.
Metastatic esophageal carcinoma to the oral cavity has been rarely reported, and most cases were adenocarcinoma metastasizing to the mandible. This first report of a case of metastatic esophageal squamous cell carcinoma to the floor of the mouth is crucial due to its rarity and difficulties in diagnosing and managing this condition.
A 53-year-old male had a painful submucosal mass on the left side of the floor of the mouth for 2 months. A biopsy indicated a moderately differentiated squamous cell carcinoma. Six months before the intraoral mass appeared, the patient had a moderately differentiated squamous cell carcinoma of the thoracic esophagus and was treated with concurrent chemoradiotherapy. With the previous history and pathological review, the diagnosis of metastatic esophageal squamous cell carcinoma to the floor of the mouth was made. Panendoscopy and an 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan revealed no other abnormality or other distant metastasis. The patient underwent surgical resection with postoperative chemoradiotherapy. He was able to take a regular diet and had good speech function. Ten months after treatment completion, he has had recurrent disease at the floor of the mouth with lung metastasis.
Oral metastasis from esophageal squamous cell carcinoma is very rare and should be differentiated from primary oral cancer using clinical and pathological features. 18F-fluorodeoxyglucose positron emission tomography-computed tomography scanning is the preferred imaging method to exclude primary tumor persistence and other metastases. Treatment is usually palliative; however, function-preserving surgery may be an option for a patient with limited disease in the oral cavity.
口腔转移性食管癌鲜有报道，大多数病例为转移至下颌骨的腺癌。这例口腔底部转移性食管鳞状细胞癌的首例报告至关重要，因其罕见且在诊断和处理该病症方面存在困难。
一名53岁男性，口腔底部左侧有一疼痛性黏膜下肿物2个月。活检显示为中分化鳞状细胞癌。在口腔肿物出现前6个月，该患者患有胸段食管中分化鳞状细胞癌，并接受了同步放化疗。结合既往病史及病理检查结果，诊断为口腔底部转移性食管鳞状细胞癌。全面内镜检查及18F - 氟脱氧葡萄糖正电子发射断层扫描 - 计算机断层扫描显示无其他异常或远处转移。患者接受了手术切除及术后放化疗。他能够正常饮食，言语功能良好。治疗结束10个月后，其口腔底部出现复发病灶并伴有肺转移。
食管鳞状细胞癌的口腔转移非常罕见，应根据临床和病理特征与原发性口腔癌相鉴别。18F - 氟脱氧葡萄糖正电子发射断层扫描 - 计算机断层扫描是排除原发性肿瘤残留及其他转移的首选影像学检查方法。治疗通常为姑息性治疗；然而，对于口腔病变局限的患者，保留功能的手术可能是一种选择。
