Isolated Colonic Metastasis From Esophageal Adenocarcinoma

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Esophageal cancer, particularly adenocarcinoma, is highly lethal with a high death-to-incidence ratio.
• Barrett's esophagus is a known precursor to esophageal adenocarcinoma.
• Metastatic spread is a common cause of mortality in esophageal cancer.

Purpose of the Study:

• To report an extremely rare case of isolated colonic metastasis from esophageal adenocarcinoma.
• To discuss the diagnostic challenges associated with detecting such rare metastatic patterns.
• To emphasize the potential limitations of positron emission tomography in identifying all metastatic sites.

Main Methods:

• Case report of a 60-year-old male with Barrett's esophagus and dysphagia.
• Diagnostic confirmation via upper endoscopy with biopsy, revealing invasive esophageal adenocarcinoma.
• Preoperative colonoscopy to investigate a colonic nodule, confirmed as metastatic.

Main Results:

• Invasive esophageal adenocarcinoma was confirmed.
• Positron emission tomography scan initially showed no evidence of metastasis.
• A colonic nodule, identified preoperatively, was histopathologically confirmed as a metastasis from the esophageal primary tumor.

Conclusions:

• Isolated colonic metastasis from esophageal adenocarcinoma is an exceptionally rare presentation.
• Standard imaging modalities like positron emission tomography may not detect all metastatic lesions.
• This case underscores the importance of thorough preoperative evaluation, including colonoscopy, in select esophageal cancer patients.