Clin Endosc.  2013 Mar;46(2):197-200. 10.5946/ce.2013.46.2.197.

A Case of Esophageal Squamous Cell Carcinoma with Pancreatic Metastasis

• Park C
• Jang JY
• Kim YH
• Hwang EJ
• Na KY
• Kim KY
• Park JH
• Chang YW

• KMID: 1805306
• DOI: http://doi.org/10.5946/ce.2013.46.2.197

Abstract

Solitary pancreatic metastasis of esophageal cancer is extremely rare. We report the case of a 58-year-old male admitted with esophageal cancer. Additional asymptomatic solitary hepatic and pancreatic masses were observed in the staging work-up for esophageal cancer. The hepatic mass was confirmed as a primary hepatocellular carcinoma with an ultrasound-guided needle biopsy. An esophagectomy with a distal pancreatectomy and radiofrequency ablation for hepatocellular carcinoma were performed. Histologically, the pancreatic mass was confirmed to be a metastasis from the esophageal cancer. The patient has been followed up with chemotherapy.

Keyword

Neoplasm metastasis; Esophageal neoplasms; Squamous cell carcinoma

MeSH Terms

Biopsy, Needle
Carcinoma, Hepatocellular
Carcinoma, Squamous Cell
Esophageal Neoplasms
Esophagectomy
Humans
Male
Neoplasm Metastasis
Pancreatectomy
Carcinoma, Squamous Cell
Esophageal Neoplasms

Figure

• 

  Fig. 1 Endoscopic finding shows a 3×4-cm erythematous lesion with an irregular nodular surface extending between 38 and 41 cm from the incisors in the 9 to 1 o'clock position.

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  Fig. 2 (A, B) Abdomen computed tomography (CT) scans demonstrate about 3 cm-sized hypodense lesion on the inferior of the pancreas (red arrow) and another hypodense lesion approximately 1.4 cm in size on the right hepatic lobe (blue arrow) were detected on abdominal CT.

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  Fig. 3 Histological examination of liver biopsy specimen. Irregularly arranged, thickened liver cell plates, suggesting hepatocellular carcinoma (H&E stain, ×200).

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  Fig. 4 Histological examination of the mass in (A) esophagus and (B) pancreas showing squamous cell carcinoma (H&E stain, ×200).

Reference

1. Sears HF, Kim Y, Strawitz J. Squamous cell carcinoma of the pancreas. J Surg Oncol. 1980; 14:261–265. PMID: 7392648.

2. Beyer KL, Marshall JB, Metzler MH, Poulter JS, Seger RM, Díaz-Arias AA. Squamous cell carcinoma of the pancreas. Report of an unusual case and review of the literature. Dig Dis Sci. 1992; 37:312–318. PMID: 1735353.

3. Itani KM, Karni A, Green L. Squamous cell carcinoma of the pancreas. J Gastrointest Surg. 1999; 3:512–515. PMID: 10482708.

4. Brown HA, Dotto J, Robert M, Salem RR. Squamous cell carcinoma of the pancreas. J Clin Gastroenterol. 2005; 39:915–919. PMID: 16208119.

5. Al-Shehri A, Silverman S, King KM. Squamous cell carcinoma of the pancreas. Curr Oncol. 2008; 15:293–297. PMID: 19079631.

6. Mulkeen AL, Yoo PS, Cha C. Less common neoplasms of the pancreas. World J Gastroenterol. 2006; 12:3180–3185. PMID: 16718837.

7. Nakashima H, Hayakawa T, Hoshino M, et al. Squamous cell carcinoma of the pancreas with massive invasion of the retroperitoneum. Intern Med. 1995; 34:61–64. PMID: 7718985.

8. Masetti M, Zanini N, Martuzzi F, et al. Analysis of prognostic factors in metastatic tumors of the pancreas: a single-center experience and review of the literature. Pancreas. 2010; 39:135–143. PMID: 19820422.

9. Adsay NV, Andea A, Basturk O, Kilinc N, Nassar H, Cheng JD. Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature. Virchows Arch. 2004; 444:527–535. PMID: 15057558.

10. Torres-Villalobos G, Podgaetz E, Anthon FJ, Remes-Troche JM, Robles-Diaz G, Nuñez CC. Single pancreatic metastasis from a previously resected carcinoma of the cecum: a case report. Curr Surg. 2004; 61:328–330. PMID: 15165777.

11. Hiotis SP, Klimstra DS, Conlon KC, Brennan MF. Results after pancreatic resection for metastatic lesions. Ann Surg Oncol. 2002; 9:675–679. PMID: 12167582.

12. Woo SM, Park JW, Han SS, et al. Isolated pancreatic metastasis of hepatocellular carcinoma after curative resection. World J Gastrointest Oncol. 2010; 2:209–212. PMID: 21160600.

13. Varker KA, Muscarella P, Wall K, Ellison C, Bloomston M. Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection. World J Surg Oncol. 2007; 5:145. PMID: 18162131.