Successful endoscopic resection of an esophageal metastasis from a preceding squamous-cell tonsillar carcinoma

This report describes the case of a 62-year-old man with tonsillar carcinoma who had undergone esophagectomy due to an esophageal metastasis. Subsequently, a second metastasis occurred in the residual esophagus, and he presented for evaluation for local endoscopic therapy. The initial upper endoscopy revealed a type IIa - c lesion at 21 cm from the incisors, within a segment suspicious for Barrett's mucosa. As part of the complex treatment approach in this patient, endoscopic resection of the lesion was carried out using the suck-and-cut technique with ligation. Histology showed that the lesion was a metastasis from a squamous-cell carcinoma, with focal infiltration of the upper submucosal layer and vascular invasion consistent with the hypothesis of hematogenous spread from the preceding tonsillar carcinoma. The resection margins were tumor-free. At the time of writing, the patient had been recurrence-free for more than 9 months. In summary, the present paper describes a unique case of successful endoscopic resection of an esophageal metastasis associated with an antecedent tonsillar carcinoma.