An Entirely Atypical Presentation of Esophageal Squamous Cell Cancer with Pancreatic and Bone Metastases

Few cases of solitary pancreatic metastases from esophageal cancer have been reported; however, these previous cases all describe a solid pancreatic mass. We present a unique case of a 67-year-old man with squamous cell carcinoma detected within a pancreatic cystic lesion that was sampled with endoscopic ultrasound-guided fine needle aspiration. Esophagogastroduodenoscopy identified a friable and fungating partially obstructing mass in the distal esophagus with features of fistulization into the lung. Pathology showed esophageal squamous cell cancer. An isolated bone lesion was also biopsied and revealed squamous cell cancer. The patient tolerated oral intake and a multidisciplinary decision was made for palliative care with home hospices given his comorbidities portending poor operative candidacy and overall poor prognosis secondary to multiple sites of metastases from his esophageal squamous cell cancer.