Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website http://www.journalmc.org

Case Report

Volume 7, Number 2, February 2016, pages 60-65

An Unusual Presentation of Esophageal Cancer: A Case Report and Review of Literature

Figures

Figure 1.
Figure 1. Computed tomography (CT) scan of the chest (coronal view) showing circumferential thickening and irregular enlargement of the esophagus with wall thickening and dilatation.
Figure 2.
Figure 2. The EGD scope was advanced into the esophagus and almost immediately, a 22 cm friable fungating mass was seen. There were multiple esophageal masses, which appeared separate.
Figure 3.
Figure 3. The EGD reveals this friable and fungating mass 30 cm from the incisors.
Figure 4.
Figure 4. The EGD revealed this friable, large, and smooth mass 35 cm from the incisors.
Figure 5.
Figure 5. Hematoxylin and eosin (H&E) stain (× 100) showing luminal part of malignant glands of adenocarcinoma and submucosal invasive adenocarcinoma showing extracellular mucin. Arc-shaped pink-colored smooth muscle fibers of muscularis mucosae separate the malignant mucosa in the left half of the picture from the submucosal invasive adenocarcinoma in the right half.
Figure 6.
Figure 6. Hematoxylin and eosin stain (H&E) (× 200) showing higher magnification of submucosal invasive adenocarcinoma showing extracellular mucin. Submucosal invasive adenocarcinoma shows pleomorphic and hyperchromatic nuclei of the columnar cells with loss of polarity. Submucosal invasive adenocarcinoma is lying under the arc-shaped pink-colored smooth muscle fibers of muscularis mucosae.
Figure 7.
Figure 7. Hematoxylin and eosin (H&E) stain (× 400) showing higher magnification of another area of adenocarcinoma with cribriform structures composed of pleomorphic and hyperchromatic nuclei showing a few prominent nucleoli. A few mitotic figures are also seen.

Table

Table 1. Review of the Literature for Esophageal Cancer With an Unusual Presentation [9, 10, 25-38]
 
ReferenceAgeGenderComorbiditiesUncommon presentationFinal diagnosisTreatmentOutcome
[9]51MMS, chronic smokerDiffuse painless solid skin nodulesMetastasis from esophageal cancerPalliative chemotherapy
[10]53MAlcohol abuse, chronic smokerUpper abdominal pain, post-prandial fullness, nausea, vomitingSquamous cell carcinoma of the esophagusPalliative therapyPoor
[25]50MChronic smokerLeft gluteal mass, dysphagia, odynophagia, weight lossMetastasis from esophageal cancerPalliative radiotherapyPoor
[26]58MGERD, hyperlipidemiaSevere right hip painSkeletal muscle metastasis from esophageal cancer--
[27]35FNonePainful right lump breast mass, weight lossMetastasis from esophageal cancerRadiation therapy, chemotherapy-
[28]58FEsophageal cancer s/p esophago-gastrectomyOccipital lesionMetastasis after esophago-gastrectomy from esophageal cancer--
[29]68MNoneDysphagia, cutaneous nodulesMetastasis from esophageal cancerChemotherapy, radiation therapy-
[29]73MEsophageal cancer s/p esophago-gastrectomyCutaneous nodulesMetastasis after esophago-gastrectomy from esophageal cancerChemotherapy, radiation therapy-
[30]59MChronic smoker, chronic bronchitisCervical pain and limited neck mobilizationMetastasis from esophageal cancer
[31]61MNoneDyspnea, dysphagia, hoarseness, palpable thyroid noduleMetastasis from esophageal cancer-Deceased due to advanced esophageal cancer
[32]54MChronic alcohol, chronic smokerDysphagia, weight loss, solitary jejunal metastasisMetastasis from esophageal cancerSurgery and chemotherapySurvived
[33]55MEsophageal cancerAdrenal massMetastasis from esophageal cancer--
[34]60FNoneOsteolytic lesion on the femurMetastasis from esophageal cancer--
[34]42FNoneOsteolytic lesion on the left tibiaMetastasis from esophageal cancer--
[34]24MNoneOsteolytic lesion on the left iliac boneMetastasis from esophageal cancer--
[34]60FChronic smoker, opiate drug addictionOsteolytic lesion on the seventh cervical vertebraMetastasis from esophageal cancer--
[34]40MNoneOsteolytic lesion on the sixth and seventh ribsMetastasis from esophageal cancer--
[35]51MEsophageal cancerDyspneaTracheal stenosis secondary to esophageal cancerTracheal stent, jejunostomy tube for feeding, local radiotherapyDeceased
[36]66MChronic alcohol abuse, chronic smokerSwelling of the neck and chest, thyroid massMetastasis from esophageal cancer-Deceased
[37]60MEsophageal cancer s/p radiotherapy and chemotherapyHeadaches, space-occupying lesion per CT scan 2 years after chemotherapy and radiation therapyMetastasis from esophageal cancerSurgerySurvived
[38]50MChronic smokerLeft upper abdominal pain, splenic lesionMetastasis from esophageal cancerChemotherapy and radiation therapySurvived
Our study49FHypothyroidism, AnxietyChronic coughEsophageal cancer??