Takaki Tomotaka, Kobayashi Shinichiro, Okano Shinji, Enjyoji Takahiro, Murakami Shunsuke, Onumata Jun, Matsukuma Mika, Maruya Yasuhiro, Kanetaka Kengo, Eguchi Susumu
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki, 852-8501, Japan.
Department of Surgery, Sapporo City General Hospital, Hokkaido, Japan.
Clin J Gastroenterol. 2025 Jun 19. doi: 10.1007/s12328-025-02164-5.
The postoperative recurrence rate of esophageal cancer ranges from 28 to 47%, with recurrences often affecting distant organs such as the lungs, liver, bones, and brain. However, colonic metastasis is rare. This report presents a case of transverse colon metastasis after radical resection of esophageal cancer in a 70-year-old man. The patient underwent neoadjuvant chemotherapy followed by esophagectomy for advanced esophageal cancer 15 months ago. He reported loss of appetite during a routine outpatient visit, and computed tomography revealed bowel obstruction and intussusception with a tumorous lesion in the transverse colon. Positron emission tomography did not reveal any abnormal accumulation in other areas. Based on these findings, a transverse colectomy was performed. Pathological examination of the resected specimen revealed squamous cell carcinoma components in the normal colonic mucosa, which were diagnosed as colonic metastases from the esophageal cancer. Postoperatively, the patient recovered uneventfully and commenced adjuvant therapy with capecitabine monotherapy, which was later discontinued at the patient's request. Four months post-surgery, liver metastasis developed, and the patient underwent immunochemotherapy. Colorectal metastasis from esophageal cancer is relatively rare, making preoperative diagnosis challenging. Nonetheless, a multidisciplinary approach combining surgery and perioperative systemic therapy has the potential to improve patient outcomes.
食管癌术后复发率在28%至47%之间，复发常累及远处器官，如肺、肝、骨和脑。然而，结肠转移很少见。本报告介绍了一例70岁男性食管癌根治术后发生横结肠转移的病例。该患者15个月前接受了新辅助化疗，随后因晚期食管癌接受了食管切除术。他在一次常规门诊就诊时报告食欲不振，计算机断层扫描显示肠梗阻和肠套叠，横结肠有肿瘤性病变。正电子发射断层扫描未显示其他部位有任何异常聚集。基于这些发现，进行了横结肠切除术。切除标本的病理检查显示正常结肠黏膜中有鳞状细胞癌成分，诊断为食管癌的结肠转移。术后，患者恢复顺利，并开始接受卡培他滨单药辅助治疗，后来应患者要求停药。术后四个月，发生肝转移，患者接受了免疫化疗。食管癌的结直肠转移相对少见，术前诊断具有挑战性。尽管如此，手术与围手术期全身治疗相结合的多学科方法有可能改善患者的预后。
