Esophageal cancer with metastases to skeletal muscles - A case report

Abstract

 Aim- To report a rare case of esophageal cancer with metastases to skeletal muscles.
Case report- 69 year old male, chronic smoker presented in 2013 with dysphagia for three months,
diagnosed to have adenosquamous carcinoma of upper thoracic Esophagus and was treated with
concurrent chemoradiation with RT TD 54Gy to primary and nodal regions along with three cycles of
weekly cisplatin. On March 2014, patient was diagnosed to have metastases to calf muscle and
gluteus maximus which after IHC correlation was found to be secondaries from esophageal primary.
Patient received palliative irradiation to the same with TD 30 Gy and was on follow-up. He again had
metastases to Right popliteus and left shoulder and was irradiated to popliteal region. Patient on
treatment developed pathological fracture of right tibia and was on supportive care. Patient died due
to progressive disease on December 2014. Discussion- Esophageal cancers have a poor five year
overall survival with concurrent chemoradiation or surgery. Esophageal cancers usually metastasize
to liver, lung or bone. Skeletal muscle metastases usually are rare and account for 1-2 of all
metastases. Treatment is usually with palliative irradiation or chemotherapy. Patients with such
metastases have a poor prognosis with Overall survival ranging from 6 to 24 months. Conclusion-
Skeletal muscle metastases are rare with esophageal cancers and should be always borne on mind
while presenting with lump earlier diagnosis due to better imaging modality might result in earlier
treatment which might improve local control and quality of life.