XXVII Metastatic Carcinoma to the Esophagus

Publisher Website
Google Scholar
Abstract
Metastatic cancer to the esophagus is not common. It may be involved by extension of a primary tumor from a contiguous organ such as the larynx, trachea, bronchi, stomach, thyroid, or hypopharynx. These tumors may produce esophageal symptoms, notably dysphagia, but the diagnosis and management of these lesions is essentially that of the primary tumor. True metastasis from distant primaries has been recorded in tumors which arose in the breast, pharynx, pancreas, testis, eye, tongue, prostate, and tibia, with one case reported arising from an undiscovered primary. Seven cases are presented. One is probably an example of a 2nd primary arising in the esophgus following cancer of the larynx. The possibility of this being a metastatic tumor cannot be excluded. A 2nd case is a primary tumor of the pharynx with metastasis to the cervical esophagus. Five cases of carcinoma of the breast with metastatic involvement of the esophagus are presented. Asymptomatic metastatic carcinoma to the esophagus was reported in slightly more than half of a series of autopsy cases. All of the cases presented had symptoms of esophageal disease. Of the 6 cases believed to be examples of true metastatic tumor none showed intralumenal fungations. The esophagoscopic appearance is strongly suggestive of cicatricial stricture rather than neoplasm. Positive endoscopic biopsies are difficult to obtain. It would appear that in tumors of the breast metastasizing to the esophagus, tumor invasion or interference with the nutrition of the esophageal wall creates an unusually friable esophagus which is much less tolerant of manipulation, particularly dilatation, than primary carcinomas of the esophagus exhibit.

This publication has 0 references indexed in Scilit: