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Hassanain H, Hassanain O, Abdelrahim M. The Uncharted Territories of Esophageal Cancer with Cardiac and Skeletal Muscle Metastasis: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1146. [PMID: 39064572 PMCID: PMC11278847 DOI: 10.3390/medicina60071146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/28/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Background: Esophageal cancer (EC) comprises 1% of all diagnosed cancers in the USA. It is more common in other parts of the world. If there is distant metastasis, the relative survival rate is 6%. There are no standardized screening methods for EC. Case Presentation: We reported a four-year case of esophageal cancer, a P53-positive mutation with atypical distant metastasis to the cardiac and skeletal muscles. The patient was managed with multimodal therapy, including immunotherapy, which could have been a factor in prolonged survival. Conclusions: Distant metastases are typically seen postmortem, and with prolonged survival, we are able to find such unique metastases antemortem. Despite a history of negative scans, the patient's ctDNA (circulating tumor DNA) remained positive, which was a better predictor of recurrence in this case. Future research is required to establish cost-effective screening methods and standardized treatments.
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Affiliation(s)
- Hala Hassanain
- Department of Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA
- Burroughs Wellcome Fund Fellow, Texas A&M Academy of Physician Scientists, Houston TX 77030, USA
| | - Omar Hassanain
- Department of General Surgery, Swedish Medical Center, Englewood, CO 80113, USA
| | - Maen Abdelrahim
- Section of GI Oncology, Department of Medical Oncology, Houston Methodist Neal Cancer Center, Houston, TX 77429, USA
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Bashti M, DeLong C, Gurses ME, Lu VM, Merenzon M, Morell A, Daggubati L, Komotar RJ, Shah AH, Ivan ME. Surgical Management of Brain Metastasis from Esophageal Cancer: A Systematic Review and Single-Center Experience. World Neurosurg 2024; 187:e568-e576. [PMID: 38704143 DOI: 10.1016/j.wneu.2024.04.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Brain metastases from esophageal cancer (BMEC) are rare and aggressive, with limited literature on optimal treatment modalities and a standard of care yet to be established. The objective of this study was to systematically review existing literature and perform a retrospective analysis of our institution's patients to evaluate the influence of different treatment modalities on patient outcomes. METHODS A systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and a retrospective review of our institutional experience with BMEC were both conducted. Data based on mean survival,histology, metastasis location, and treatment modality were abstracted. RESULTS A total of 48 studies representing 136 patients with BMEC were identified, in addition to the 11 patients treated at our institution. There were a total of 100 males (12 unreported), with a median age of 62.2 at diagnosis in our systematic review, along with 8 males with a median age of 62 in our institutional review. Collectively, survival rates observed based on histology were not similar (squamous cell carcinoma: 9.2 months, adenocarcinoma: 13.4 months), however, based on treatment modalities (surgery: 11.6 months, radiation: 10.4 months, chemotherapy: 12.3 months), and metastasis location (supratentorial: 10.5 months, infratentorial: 9.9 months), the survival times were comparable. CONCLUSIONS Our review suggests that causes of death were often independent of brain metastases highlighting the need for further studies on early detection and prevention of primary esophageal cancer, as well as improved treatment modalities for BMECs.
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Affiliation(s)
- Malek Bashti
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA.
| | - Chase DeLong
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Muhammet Enes Gurses
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Victor M Lu
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Martín Merenzon
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Alexis Morell
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Lekhaj Daggubati
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ricardo Jorge Komotar
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA; Sylvester Cancer Center, University of Miami Health System, Miami, Florida, USA
| | - Ashish H Shah
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Michael E Ivan
- Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, Florida, USA; Sylvester Cancer Center, University of Miami Health System, Miami, Florida, USA
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3
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Fan NJ, Zhai ST, Lv XX, Li FL, Yan J, Xing PY, Cao YS, Yun T, Yuan XT, Meng NL, Wang CS. Esophageal squamous cell carcinoma metastases to kidney and renal hilar lymph nodes through epithelial-mesenchymal transition: a case report and literature review. Am J Transl Res 2024; 16:1825-1833. [PMID: 38883393 PMCID: PMC11170601 DOI: 10.62347/cqbs7463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Esophageal cancer (EC) metastasized to the kidney is extremely rare clinically. Here, we present a case of metachronous renal metastasis of esophageal squamous cell carcinoma (ESCC) through epithelial-mesenchymal transition (EMT). CASE PRESENTATION A 60-year-old patient, male, complained of left waist pain for 5 days, 11 months after radical esophagectomy. Laboratory tests revealed haematuria. Both CT and PET-CT scan showed retroperitoneal lymph nodes and left renal masses. Subsequently the patient received a left nephrectomy and lymph nodes resection, and squamous cell carcinoma of kidney and renal hilar lymph nodes was diagnosed, combined with morphology, medical history and immunophenotype, it was presumed to be metastasis of ESCC through the EMT pathway. CONCLUSIONS The renal metastasis of squamous cell carcinoma should be considered in patients with history of EC, although this is very rare. Histopathological examination combined with immunochemical detection is helpful in differential diagnosis.
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Affiliation(s)
- Nai-Jun Fan
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Shu-Ting Zhai
- Department of Pathology, The Third People's Hospital of Luoyang Luoyang 471000, Henan, China
| | - Xue-Xia Lv
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Fu-Lin Li
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Jin Yan
- Diagnostic Imaging Center, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Peng-Yi Xing
- Diagnostic Imaging Center, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Yan-Sha Cao
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Tian Yun
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Xu-Tao Yuan
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Nian-Long Meng
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
| | - Chang-Song Wang
- Department of Pathology, People's Liberation Army Joint Logistic Support Force 989th Hospital Luoyang 471000, Henan, China
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Brandon A, Singh KB, Sonnier W. The Chest Wall Mass of Unknown Origin: A Rare Presentation of Esophageal Adenocarcinoma. Cureus 2024; 16:e59209. [PMID: 38807814 PMCID: PMC11131598 DOI: 10.7759/cureus.59209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/30/2024] Open
Abstract
A chest wall mass can result from a diversity of underlying disease processes ranging from benign to a site of distant metastasis. The chest wall is a rare site for esophageal adenocarcinoma (EAC) metastasis. Delayed diagnosis can occur when presenting symptoms are not typical of esophageal pathology, and advanced-stage EAC has a high morbidity and low survival rates. Our case demonstrates a rare and unusual presentation of EAC with a poor outcome due to delayed diagnosis.
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Affiliation(s)
- Arcole Brandon
- College of Medicine, University of South Alabama, Mobile, USA
| | - Karan B Singh
- Internal Medicine, University of South Alabama, Mobile, USA
| | - William Sonnier
- Gastroenterology and Hepatology, University of South Alabama, Mobile, USA
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Pal P, Mohan A, Kaur R, Kaur G, Singh B. Intraoperative Facial Nerve Involvement in Parotid Tumours - A Retrospective Analysis in a Tertiary Care Centre. Indian J Otolaryngol Head Neck Surg 2024; 76:1972-1978. [PMID: 38566689 PMCID: PMC10982282 DOI: 10.1007/s12070-024-04478-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/31/2023] [Indexed: 04/04/2024] Open
Abstract
Purpose The study aims to provide a comprehensive overview of the various malignant and benign parotid tumours and evaluate the predictive factors for intraoperative nerve involvement leading to facial palsy (FP). Methods It is a single-centre retrospective analysis for reviewing the involvement of facial nerve in post- parotidectomy patients. The clinical database from January 2012 to December 2020 was included in the study with a follow-up period of a minimum of 2 years. To maintain homogeneity, all squamous cell carcinomas of level 2 nodes involving parotid or residual/recurrent disease of the oral cavity requiring parotid dissection were excluded. Results A total of 248 patients (171 benign; 77 malignant) were evaluated with a mean age of 46.48 ± 10.76 years. The presence of malignancy increases the risk of FP (p = 0.027). 37 (14.92%) patients with FP were detected which included 34 with partial [32.35% in malignant; 62.16% in recurrent pleomorphic adenoma (RPA)] and 3 with total paralysis (66.67% in malignant; 33.33% in RPA). The recurrence of pleomorphic adenoma increases FP. While old age, larger size, hard fixed swelling with masseteric space (MS) infiltration appeared as risk factors for FP in malignant tumours (p = 0.047; p = 0.004; p < 0.00001 respectively). Conclusion Tumour size, malignancy, hard fixed mass, masseteric space infiltration, recurrence, and age > 45yrs have been statistically significant predictive factors for intraoperative facial nerve involvement leading to FP. The study also revealed that FP occurred more commonly when there was concurrent involvement of both superficial and deep lobes but was not statistically significant.
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Affiliation(s)
- Pooja Pal
- Otolaryngology & Head Neck Surgery, Sri Guru Ram Das Institute of Medical Sciences, Amritsar, India
| | - Ankur Mohan
- Otolaryngology & Head Neck Surgery, AIIMS Bathinda, Bathinda, India
| | - Rupinder Kaur
- Surgical Oncology, Government Medical College Amritsar, Amritsar, India
| | - Gurkiran Kaur
- Otolaryngology & Head Neck Surgery, Postgraduate Institute of Medical Education & Research (PGIMER), Sangrur, India
| | - Bikramjit Singh
- Professor & Head of Department, Surgical Oncology, Government Medical College Amritsar, Amritsar, India
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Yang YL, Qin HW, Chen ZY, Fan HN, Yu Y, Da W, Zhu JS, Zhang J. Detachable string magnetically controlled capsule endoscopy for the noninvasive diagnosis of esophageal diseases: A prospective, blind clinical study. World J Gastroenterol 2024; 30:1121-1131. [PMID: 38577194 PMCID: PMC10989486 DOI: 10.3748/wjg.v30.i9.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/14/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Traditional esophagogastroduodenoscopy (EGD), an invasive examination method, can cause discomfort and pain in patients. In contrast, magnetically controlled capsule endoscopy (MCE), a noninvasive method, is being applied for the detection of stomach and small intestinal diseases, but its application in treating esophageal diseases is not widespread. AIM To evaluate the safety and efficacy of detachable string MCE (ds-MCE) for the diagnosis of esophageal diseases. METHODS Fifty patients who had been diagnosed with esophageal diseases were prospectively recruited for this clinical study and underwent ds-MCE and conventional EGD. The primary endpoints included the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ds-MCE for patients with esophageal diseases. The secondary endpoints consisted of visualizing the esophageal and dentate lines, as well as the subjects' tolerance of the procedure. RESULTS Using EGD as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%, 86.21%, 81.82%, 89.29%, and 86%, respectively. ds-MCE was more comfortable and convenient than EGD was, with 80% of patients feeling that ds-MCE examination was very comfortable or comfortable and 50% of patients believing that detachable string v examination was very convenient. CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD, providing a novel noninvasive method for treating esophageal diseases.
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Affiliation(s)
- Yan-Ling Yang
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Huang-Wen Qin
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Zhao-Yu Chen
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Hui-Ning Fan
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Yi Yu
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Wei Da
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Jin-Shui Zhu
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Jing Zhang
- Department of Gastroenterology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
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Murthy J, Moise J, Mi K, Aulakh S. Esophageal Adenocarcinoma Presenting as an Isolated Brain Lesion 6 Years After Treatment. ACG Case Rep J 2024; 11:e01263. [PMID: 38374924 PMCID: PMC10876248 DOI: 10.14309/crj.0000000000001263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/21/2023] [Indexed: 02/21/2024] Open
Abstract
Intracranial metastasis is a rare sequela of esophageal adenocarcinoma (EAC), typically presenting within the first 2 years after primary tumor detection. Our patient is a 72-year-old man diagnosed with an EAC in 2015 and presented with recurrence of a distant solitary brain lesion approximately 6 years after the initial diagnosis. Histological diagnosis was confirmed as EAC with all relevant indicators. In addition, we used genomic profiling to detect biomarkers that can be useful in the future for therapies.
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Affiliation(s)
- Jeevan Murthy
- West Virginia University School of Medicine, Morgantown, WV
| | - John Moise
- West Virginia University School of Medicine, Morgantown, WV
| | - Kaitlyn Mi
- Vanderbilt University School of Medicine, Nashville, TN
| | - Sonikpreet Aulakh
- West Virginia University School of Medicine, Morgantown, WV
- Division of Hematology-Oncology, West Virginia University Cancer Institute, Morgantown, WV
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Ibrahim-Shaikh S, Shaikh N, Daboul N, Alshaikhnassir E, Hafez M, Freiser ME. Metastatic Esophageal Adenocarcinoma Presenting as Neck Dermal Metastasis. Case Rep Dermatol Med 2024; 2024:7951391. [PMID: 38264294 PMCID: PMC10805548 DOI: 10.1155/2024/7951391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/18/2023] [Accepted: 11/15/2023] [Indexed: 01/25/2024] Open
Abstract
Dermal metastasis is a rare manifestation of visceral disease, and esophageal adenocarcinomas represent around only 1% of primaries that present with cutaneous metastasis. In this case, we discuss a patient who presented with a painless submental mass and extensive right neck cutaneous induration and erythema. Core needle biopsy demonstrated poorly differentiated adenocarcinoma. Blood testing also demonstrated elevated carbohydrate antigen 19-9, carcinoembryonic antigen, and alkaline phosphatase. PET/CT followed by esophagoscopy led to the diagnosis of esophageal signet-cell adenocarcinoma primary with isolated dermal metastasis. The patient was started on palliative radiotherapy and passed away two months later from a suspected thoracic fistula and hydropneumothorax.
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Affiliation(s)
| | - Noah Shaikh
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Nour Daboul
- Department of Hematology/Oncology, West Virginia University, Morgantown, West Virginia, USA
| | - Esra Alshaikhnassir
- Department of Pathology, West Virginia University, Morgantown, West Virginia, USA
| | - Maria Hafez
- Department of Hematology/Oncology, West Virginia University, Morgantown, West Virginia, USA
| | - Monika E. Freiser
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
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Garcia A, Morris N, Francis P, Baik D. Rare Metastasis of Esophageal Adenocarcinoma to the Female Reproductive Tract. ACG Case Rep J 2024; 11:e01233. [PMID: 38179264 PMCID: PMC10766279 DOI: 10.14309/crj.0000000000001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024] Open
Abstract
Esophageal cancer is common and typically metastasizes to the liver, lung, and lymph nodes. Reproductive tract metastases are extremely rare. In fact, to the best of our knowledge, only 2 cases of esophageal carcinoma metastasizing to the ovaries have been reported. Thus, increased recognition of unusual metastatic sites is necessary to decrease the morbidity and mortality from distant esophageal metastases. We present a case of ovarian and fallopian tube metastases from esophageal adenocarcinoma in a 59-year-old woman.
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Affiliation(s)
- Alexander Garcia
- Department of Internal Medicine, Cooper University Hospital, Camden, NJ
| | | | - Pilin Francis
- Department of Gastroenterology, Cooper University Hospital, Camden, NJ
| | - Daniel Baik
- Department of Gastroenterology, Cooper University Hospital, Camden, NJ
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Kang M, Zhu L, Yang M, Zhang Y, Wang S, Wang Y. Rare presentation of esophageal squamous cell carcinoma with rectal metastasis: A case report. Oncol Lett 2023; 26:510. [PMID: 37920430 PMCID: PMC10618916 DOI: 10.3892/ol.2023.14097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/19/2023] [Indexed: 11/04/2023] Open
Abstract
Esophageal cancer is usually diagnosed at an advanced stage, resulting in poor survival. The common sites of distant metastasis include lung, liver and bones. The present study reports a rare case of esophageal squamous cell carcinoma (SCC) with rectal metastasis. A 65-year-old man was diagnosed with middle thoracic esophageal SCC with multiple lymph node metastasis. The patient achieved good response after chemoradiotherapy and adjuvant chemotherapy. During following up, the computed tomography and magnetic resonance scans showed a mass in front of the rectum with intact mucosa. Biopsies were performed and histopathological findings showed SCC, consistent with metastasis from primary esophageal SCC. The patient subsequently received palliative chemoradiotherapy to the rectal tumour and survived for 5 months. To the best of our knowledge, the present case is the first report of metastatic rectal SCC from the esophagus. It is important to take a biopsy of this unexpected lesion for histological analysis, which can help to discriminate metastatic from primary cancer. The goal of treatment is palliative therapy to improve quality of life and survival for this metastatic disease.
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Affiliation(s)
- Mei Kang
- Department of Radiation Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Liyang Zhu
- Department of Radiation Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Mingwei Yang
- Department of Radiation Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Yin Zhang
- Department of Pathology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Shiyu Wang
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
| | - Yichun Wang
- Department of Radiation Oncology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
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Yang MQ, Sun MJ, Zhang HJ. Mucosal esophageal carcinoma following endoscopic submucosal dissection with giant gastric metastasis: A case report and review of literature. World J Gastroenterol 2023; 29:5935-5944. [PMID: 38111508 PMCID: PMC10725560 DOI: 10.3748/wjg.v29.i44.5935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/15/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Esophageal carcinoma is a highly aggressive digestive cancer responsible for a notable proportion of cancer-related deaths worldwide. Its elevated metastatic rate contributes to a poor prognosis in affected patients. In this case review, we aim to summarize the metastatic characteristics of intramural gastric metastasis (IGM) in mucosal esophageal squamous carcinoma. CASE SUMMARY A 56-year-old man was admitted to our hospital because of a dry cough with an esophageal sensation for one year. Endoscopic examination revealed a 2.0 cm 1.0 cm, superficial esophageal squamous cell carcinoma, and the patient underwent endoscopic submucosal dissection (ESD). Fifteen months after ESD, positron emission tomography/computed tomography revealed that the metabolism of the stomach cardia wall had increased slightly. However, the mucosa of the gastric cardia was smooth under gastroendoscopy. Two years after ESD, endoscopic examination revealed a giant gastric cardia carcinoma, while the esophageal mucosa was smooth, and no advanced cancer was found. A biopsy of the gastric cardia indicated squamous-cell carcinoma. The patient received immunochemotherapy and radiotherapy for esophageal cancer for 8 mo and is currently under follow-up. CONCLUSION Early-stage esophageal carcinoma with IGM is rare. Despite the ESD of the primary lesion, IGM may still occur and should be closely monitored after ESD.
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Affiliation(s)
- Mei-Qi Yang
- Department of Gastroenterology, The First Hospital of China Medical University, Shenyang 110000, Liaoning Province, China
| | - Ming-Jun Sun
- Department of Endoscopy, The First Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning Province, China
| | - Hui-Jing Zhang
- Department of Gastroenterology, The First Hospital of China Medical University, Shenyang 110000, Liaoning Province, China
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12
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Hsieh YC, Wu JS. Visual change as the presenting symptom of a suspected metastatic brain lesion in esophageal cancer: A case report. Medicine (Baltimore) 2023; 102:e36014. [PMID: 38013299 PMCID: PMC10681379 DOI: 10.1097/md.0000000000036014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/18/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Esophageal cancer is the seventh most common malignancy worldwide and the sixth leading cause of cancer mortality with an overall survival rate of <20%. Esophageal cancer frequently metastasizes to distant lymph nodes, lungs, liver, and bones. Cerebral metastases originating from esophageal cancer are rare and often carry a poor prognosis as do most all metastatic lesions in esophageal cancer. CASE PRESENTATION In this report, we describe a 55-year-old patient with past history of esophageal carcinoma who presented with blurred vision after taking ethambutol for tuberculosis. Ethambutol-induced optic neuropathy was the lead diagnosis. Initial vision testing was normal so additional testing with visual field examination was warranted. The visual field examination revealed homonymous hemianopsia. Subsequent magnetic resonance imaging of his brain, demonstrated a focal lesion, consistent with but not diagnostic of a brain metastasis likely from his primary esophageal malignancy. CONCLUSION We conclude that a careful review of the medical history and comprehensive assessment are essential in establishing an obscure clinical diagnosis especially in the event that an uncommon metastatic lesion is encountered.
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Affiliation(s)
- Yun-Chen Hsieh
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
| | - Jian-Sheng Wu
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
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13
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Olawoyin OM, Khan AI, Segal DA, Lokeshwar SD, Amin J, Martin TV, Buckley TM. Esophageal adenocarcinoma with metastasis to the prostatic urethra and bladder. Urol Case Rep 2023; 50:102512. [PMID: 37547449 PMCID: PMC10400466 DOI: 10.1016/j.eucr.2023.102512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/12/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023] Open
Abstract
Metastatic esophageal adenocarcinoma to the urinary bladder is extremely rare and aggressive. We discuss here the case of an 83-year-old male with history of esophageal adenocarcinoma treated with chemoradiation therapy and esophagectomy who presented with gross hematuria and lower urinary tract symptoms. Pathology of the bladder tumor after transurethral resection demonstrated invasive adenocarcinoma of both the bladder and the prostatic urethra consistent with metastatic esophageal adenocarcinoma.
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Affiliation(s)
| | - Amir I. Khan
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | - Daniel A. Segal
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | | | - Jay Amin
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
| | - Thomas V. Martin
- Department of Urology, Yale School of Medicine, New Haven, CT, USA
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Sittitrai P, Ruenmarkkaew D, Lekawanvijit S. Esophageal squamous cell carcinoma metastasizing to the oral cavity: a case report and literature review. Ann Med Surg (Lond) 2023; 85:4603-4607. [PMID: 37663702 PMCID: PMC10473335 DOI: 10.1097/ms9.0000000000001086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/09/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction and Importance Metastatic esophageal carcinoma to the oral cavity has been rarely reported, and most cases were adenocarcinoma metastasizing to the mandible. This first report of a case of metastatic esophageal squamous cell carcinoma to the floor of the mouth is crucial due to its rarity and difficulties in diagnosing and managing this condition. Case Presentation A 53-year-old male had a painful submucosal mass on the left side of the floor of the mouth for 2 months. A biopsy indicated a moderately differentiated squamous cell carcinoma. Six months before the intraoral mass appeared, the patient had a moderately differentiated squamous cell carcinoma of the thoracic esophagus and was treated with concurrent chemoradiotherapy. With the previous history and pathological review, the diagnosis of metastatic esophageal squamous cell carcinoma to the floor of the mouth was made. Panendoscopy and an 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan revealed no other abnormality or other distant metastasis. The patient underwent surgical resection with postoperative chemoradiotherapy. He was able to take a regular diet and had good speech function. Ten months after treatment completion, he has had recurrent disease at the floor of the mouth with lung metastasis. Conclusions Oral metastasis from esophageal squamous cell carcinoma is very rare and should be differentiated from primary oral cancer using clinical and pathological features. 18F-fluorodeoxyglucose positron emission tomography-computed tomography scanning is the preferred imaging method to exclude primary tumor persistence and other metastases. Treatment is usually palliative; however, function-preserving surgery may be an option for a patient with limited disease in the oral cavity.
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Affiliation(s)
| | | | - Suree Lekawanvijit
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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15
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Han G, Zhou S, Shen J, Yang Y, Bian X, Li Y, Ling R, Liang R, Tao M. The role of TMEM26 in disrupting tight junctions and activating NF-κB signaling to promote epithelial-mesenchymal transition in esophageal squamous cell carcinoma. Clinics (Sao Paulo) 2023; 78:100276. [PMID: 37611445 PMCID: PMC10466919 DOI: 10.1016/j.clinsp.2023.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/20/2023] [Accepted: 07/31/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES Metastasis is one of the biggest challenges in the management of Esophageal Squamous Cell Carcinoma (ESCC), of which molecular mechanisms remain elusive. The present study aimed to explore the roles and underlying mechanisms of Transmembrane protein 26 (TMEM26) in ESCC. METHOD TMEM26 expressions in tumorous and adjacent tissues from patients with ESCC and in normal esophageal epithelial and ESCC cell lines were detected by immunostaining and western blotting, respectively. The Epithelial-Mesenchymal Transition (EMT), a critical process during metastasis, was investigated by wound healing and Transwell assays, and EMT-related proteins were examined after the TMEM26 alteration in ESCC cell lines. NF-κB signaling activation and Tight Junction (TJ) protein expression were analyzed by western blotting and immunofluorescence, respectively. In vivo verification was performed on the liver metastatic murine model. RESULTS Compared with non-cancerous esophageal tissues and cells, the TMEM26 expression level was higher in ESCC samples and cell lines, where the plasma membrane localization of TMEM26 was observed. The EMT-related processes of ESCC cells were suppressed by RNAi depletion of TMEM26 but aggravated by TMEM26 overexpression. Mechanistically, TMEM26 promoted NF-κB signaling to accelerate EMT in ESCC cells. The plasma membrane presentation and assembly of TJ proteins were impaired by TMEM26. CONCLUSION Overall, TMEM26 acts as a critical determinant for EMT in ESCC cells by disrupting TJ formation and promoting NF-κB signaling, which may be a potential therapeutic target for treating metastatic ESCC.
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Affiliation(s)
- Guohu Han
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China; Department of Oncology, Jingjiang People's Hospital Affiliated with Yangzhou University, Jingjiang, Jiangsu, China
| | - Shuangshuang Zhou
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Junjun Shen
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Yuanyuan Yang
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Xuyu Bian
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Yahu Li
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Rui Ling
- Department of Oncology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Rongrui Liang
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China; Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Min Tao
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China; Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
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16
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Uotani T, Tanemura M, Matsuda H, Matsumoto K, Higashi S, Nonaka R, Wakasugi M, Miyake M, Fujii T, Furukawa H. Successful multimodal therapy for the metastasis of ascending colon after curative resection of esophageal cancer: a case report with long-term survival. Clin J Gastroenterol 2023; 16:13-19. [PMID: 36333487 DOI: 10.1007/s12328-022-01728-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Solitary colonic metastasis from esophageal cancer is rare. The prognosis of patients with distant metastases from esophageal cancer is extremely poor. A case of long-term survival with colonic metastasis from esophageal cancer treated by multimodal therapy is reported. A 67-year-old man was diagnosed with middle thoracic esophageal squamous cell carcinoma. The patient received neoadjuvant chemotherapy and then underwent subtotal esophagectomy. Approximately 1 year after esophagectomy, an asymptomatic, solitary colonic mass was detected on the follow-up computed tomography for esophageal cancer. Preoperative colonoscopy showed a 5-cm type 3 tumor at the ascending colon, and histological findings of the biopsy specimen indicated possible metastasis from primary esophageal squamous cell carcinoma. The patient underwent laparoscopic ileocolic resection with D3 lymph noddle dissection. Histologically, the colonic tumor was confirmed to be a metastasis from the esophageal squamous cell carcinoma. To the best of our knowledge, only eight cases with resected solitary colonic metastasis, including the present case, have been reported, and the present patient achieved greater than 3-year survival after esophagectomy. Resection of an asymptomatic solitary organ metastasis from primary esophageal cancer appears to be a good therapeutic option, even following esophagectomy.
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Affiliation(s)
- Tomofumi Uotani
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan.,Department of Surgery and Science, Faculty of Medicine, Academic Assembly University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Masahiro Tanemura
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Hiroki Matsuda
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Kenichi Matsumoto
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Shigeyoshi Higashi
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Ryoji Nonaka
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Masaki Wakasugi
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Masakazu Miyake
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Haruna Furukawa
- Department of Surgery, Rinku General Medical Center, 2-23 Ourai-Kita, Rinku, Izumisano, Osaka, 598-8577, Japan.
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17
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Luo P, Wu J, Chen X, Yang Y, Zhang R, Qi X, Li Y. A population-based investigation: How to identify high-risk T1-2N0 esophageal cancer patients? Front Surg 2023; 9:1003487. [PMID: 36733675 PMCID: PMC9888256 DOI: 10.3389/fsurg.2022.1003487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose Newly diagnosed T1-2N0 esophageal cancer (EC) is generally deemed as early local disease, with distant metastases (DM) easily overlooked. This retrospective study aimed to describe the metastatic patterns, identify risk factors and established a risk prediction model for DM in T1-2N0 EC patients. Methods A total of 4623 T1-2N0 EC patients were identified in the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2018. Multivariable logistic regression was used to identify risk factors for DM. A nomogram was developed for presentation of the final model. Results Of 4623 T1-2N0 patients, 4062 (87.9%) had M0 disease and 561 (12.1%) had M1 disease. The most common metastatic site was liver (n = 156, 47.3%), followed by lung (n = 89, 27.0%), bone (n = 70, 21.2%) and brain (n = 15, 4.5%). Variables independently associated with DM included age at diagnosis, gender, tumor grade, primary site, tumor size and T stage. A nomogram based on the variables had a good predictive accuracy (area under the curve: 0.750). Independent risk factors for bone metastases (BoM), brain metastases (BrM), liver metastases (LiM) and lung metastases (LuM) were identified, respectively. Conclusions We identified independent predictive factors for DM, as well as for BoM, BrM, LiM and LuM. Above all, a practical and convenient nomogram with a great accuracy to predict DM probability for T1-2N0 EC patients was established.
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Affiliation(s)
- Peng Luo
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Wu
- Department of Urology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiankai Chen
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yafan Yang
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruixiang Zhang
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiuzhu Qi
- Department of Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yin Li
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Correspondence: Yin Li
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18
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Rasheed W, Usman O, Rehman OU, Fatima E, Nashwan A. Esophageal Adenocarcinoma: An Unusual Pericardial and Pulmonary Metastasis - A Case Report. Case Rep Oncol 2023; 16:1253-1258. [PMID: 37915994 PMCID: PMC10618010 DOI: 10.1159/000534359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Esophageal adenocarcinoma (EAC) manifests in the glandular cells present in the lining of the esophagus and usually forms in the distal portion of the esophagus. The metastasis of EAC has been reported to occur in surrounding lymphovascular structures, the liver, brain, and bones. Case Presentation We present the rare case of a 52-year-old Hispanic male with EAC metastasis to the pericardium and lungs. The patient presented with shortness of breath off and on for the last 6 weeks without any usually reported symptoms of EAC like chest pain, vomiting, or chronic cough. Respiratory examinations of this patient were significant for bilateral bronchial breathing and coarse crackles. The patient had been given numerous courses of oral antibiotics over the previous weeks with the provisional diagnosis of atypical pneumonia. Cardiac tamponade pathophysiology was also observed in this patient, for which a pericardial window was created to relieve the patient's symptoms. A final diagnosis of EAC with an unusual metastasis in the lungs and pericardium was made based on radiological and pathological findings. The patient chose palliative care instead of curative care because of the advanced stage of this cancer. The patient received cancer diagnosis counseling and was sent to hospice care for further management. Conclusion The metastasis of EAC to the pericardium and lungs instead of usual sites constitutes an important prognostic factor in the overall survival of patients.
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Affiliation(s)
- Waqas Rasheed
- Texas Tech University Health Sciences Center, Amarillo, TX, USA
| | - Omer Usman
- Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Obaid Ur Rehman
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Eeshal Fatima
- Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
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19
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Chen J, Zhang S, Chen J. Case report: A case of rectal metastatic squamous cell carcinoma from the esophagus. Front Oncol 2023; 13:1092868. [PMID: 36874084 PMCID: PMC9981638 DOI: 10.3389/fonc.2023.1092868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/07/2023] [Indexed: 02/19/2023] Open
Abstract
Esophageal cancer is prone to distant metastasis, and the prognosis is very poor; the occurrence of intestinal metastasis is extremely rare, with atypical clinical manifestations. We report a case of rectal metastasis after surgery for esophageal squamous cell carcinoma. The patient was a 63-year-old male who was admitted to the hospital due to progressive dysphagia. He was diagnosed with moderately differentiated esophageal squamous cell carcinoma after the surgery. He was not treated with chemoradiotherapy after surgery and had recurrent blood in his stool at 9 months post-surgery; rectal metastasis of esophageal squamous carcinoma was diagnosed based on postoperative pathology. Because the patient had a positive rectal margin, we used adjuvant chemoradiotherapy and carrelizumab immunotherapy, achieving very good short-term efficacy. The patient is currently in a state of tumor-free survival and is still being closely followed up and treated. Through this case report, we hope to deepen understanding of rare metastasis of esophageal squamous cell carcinoma and actively promote local radiotherapy plus chemotherapy and immunotherapy to improve survival.
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Affiliation(s)
- Junni Chen
- Department of Radiation Oncology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Shuai Zhang
- Department of Radiation Oncology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Jiawei Chen
- Department of Radiation Oncology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
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20
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Luo P, Wei X, Liu C, Chen X, Yang Y, Zhang R, Kang X, Qin J, Qi X, Li Y. The risk and prognostic factors for liver metastases in esophageal cancer patients: A large-cohort based study. Thorac Cancer 2022; 13:2960-2969. [PMID: 36168908 PMCID: PMC9626357 DOI: 10.1111/1759-7714.14642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This retrospective study aimed to explore risk factors for liver metastases (LiM) in patients with esophageal cancer (EC) and to identify prognostic factors in patients initially diagnosed with LiM. METHODS A total of 28 654 EC patients were retrieved from the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2018. A multivariate logistic regression model was utilized to identify risk factors for LiM. A Cox regression model was used to identify prognostic factors for patients with LiM. RESULTS Of 28 654 EC patients, 4062 (14.2%) had LiM at diagnosis. The median overall survival (OS) for patients with and without LiM was 6.00 (95% CI: 5.70-6.30) months and 15.00 (95% CI: 14.64-15.36) months, respectively. Variables significantly associated with LiM included gender, age, tumor site, histology, tumor grade, tumor size, clinical T stage, clinical N stage, bone metastases (BoM), brain metastases (BrM) and lung metastases (LuM). Variables independently predicting survival for EC patients with LiM were age, histology, tumor grade, BoM, BrM, LuM, and chemotherapy. A risk prediction model and two survival prediction models were then constructed revealing satisfactory predictive accuracy. CONCLUSIONS Based on the largest known cohort of EC, independent predictors of LiM and prognostic indicators of survival for patients with LiM were identified. Two models for predicting survival as well as a risk prediction model were developed with robust predictive accuracy.
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Affiliation(s)
- Peng Luo
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xiufeng Wei
- Department of Thoracic Surgery, Beijing Chuiyangliu HospitalChuiyangliu Hospital Affiliated to Tsinghua UniversityBeijingChina
| | - Chen Liu
- Department of Ophthalmology, Shanghai Changhai HospitalNaval Military Medical UniversityShanghaiChina
| | - Xiankai Chen
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yafan Yang
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ruixiang Zhang
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xiaozheng Kang
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jianjun Qin
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xiuzhu Qi
- Department of UltrasoundFudan University Shanghai Cancer CenterShanghaiChina,Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Yin Li
- Department of Thoracic Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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21
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Midesophageal Metastatic Disease After Treatment of Gastroesophageal Junction Adenocarcinoma. ACG Case Rep J 2022; 9:e00869. [PMID: 36212240 PMCID: PMC9534364 DOI: 10.14309/crj.0000000000000869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022] Open
Abstract
Esophageal cancer carries a significant risk of morbidity and mortality because of its poor prognosis. Adenocarcinoma is the most common type of esophageal cancer in the United States. Local metastasis within the esophagus is extremely rare and likely because of the complex esophageal lymphatic system. Our patient is a 74-year-old man with adenocarcinoma of the gastroesophageal junction treated with chemotherapy and radiation who was subsequently found to have local metastasis to the proximal esophagus.
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22
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Ruiz-Casado A, Hijos M, Ruiz R, Romero J. Orbital metastasis from oesophageal cancer. When the ophtalmologist meets gastrointestinal specialists. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:594-595. [PMID: 35879175 DOI: 10.1016/j.oftale.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- A Ruiz-Casado
- Departamento de Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | - M Hijos
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - R Ruiz
- Departamento de Radiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Romero
- Departamento de Radioterapia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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23
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Kitashiro S, Kuno I, Sugano T, Yamano Y, Shigeoka Y, Inaba M. Urethral metastasis from esophageal cancer: symptoms of dysuria and cystoscopic diagnosis. Oxf Med Case Reports 2022; 2022:omac099. [PMID: 36176944 PMCID: PMC9514107 DOI: 10.1093/omcr/omac099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/06/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Urethral malignant tumors are rare and can lead to stenosis, causing dysuria. We report a case of urethral metastasis secondary to esophageal cancer. At the time of diagnosis, a patient with esophageal squamous cell carcinoma presented with voiding difficulties, feeble stream, terminal dribbling and incomplete voiding. The urethral tumor was diagnosed using cystoscopy, and biopsy was thereafter performed. Histopathology of the urethral tumor microscopically resembled to that of esophageal cancer. On immunohistochemistry, the urothelium markers uroplakin 2 and GATA3 were negative in the carcinomatous component; however, GATA3 was detected on the lesion’s surface. This case demonstrated that esophageal cancer metastasized to the urethra. Medical oncologists should consider this diagnosis in patients with cancer presenting with dysuria.
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Affiliation(s)
- Saya Kitashiro
- Yodogawa Christian Hospital Department of Medical Oncology, , Osaka, Japan
| | - Ikumi Kuno
- Yodogawa Christian Hospital Department of Medical Oncology, , Osaka, Japan
| | - Tenyu Sugano
- Yodogawa Christian Hospital Department of Diagnostic Pathology, , Osaka, Japan
| | - Yukimasa Yamano
- Yodogawa Christian Hospital Department of Urology, , Osaka, Japan
| | - Yasushi Shigeoka
- Yodogawa Christian Hospital Department of Medical Oncology, , Osaka, Japan
| | - Mayumi Inaba
- Yodogawa Christian Hospital Department of Diagnostic Pathology, , Osaka, Japan
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Wong MCS, Deng Y, Huang J, Bai Y, Wang HHX, Yuan J, Zhang L, Yip HC, Chiu PWY. Performance of screening tests for esophageal squamous cell carcinoma: a systematic review and meta-analysis. Gastrointest Endosc 2022; 96:197-207.e34. [PMID: 35413332 DOI: 10.1016/j.gie.2022.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/04/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS This systematic review and meta-analysis aims to compare the pooled diagnostic accuracy of the currently available esophageal squamous cell carcinoma (ESCC) screening tests. METHODS A comprehensive literature search of Embase and Medline (up to October 31, 2020) was performed to identify eligible studies. We pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for ESCC screening tools using a bivariate random-effects model. The summary receiver operating characteristic curves with area under the curve (AUC) were plotted for each screening test. RESULTS We included 161 studies conducted in 81 research articles involving 32,209 subjects. The pooled sensitivity, specificity, and AUC of the major screening tools were respectively as follows: endoscopy (peroral endoscopy): .94 (95% confidence interval [CI], .87-.97), .92 (95% CI, .87-.95), and .97 (95% CI, .96-.99); endoscopy (transnasal endoscopy): .85 (95% CI, .70-.93), .96 (95% CI, .91-.98), and .97 (95% CI, .95-.98); microRNA: .77 (95% CI, .75-.80), .78 (95% CI, .75-.80), and .85 (95% CI, .81-.87); autoantibody: .45 (95% CI, .36-.53), .91 (95% CI, .89-.93), and .84 (95% CI, .81-.87); and cytology: .82 (95% CI, .60-.93), .97 (95% CI, .88-.99), and .97 (95% CI, .95-.98). There was high heterogeneity. CONCLUSIONS The diagnostic accuracy seemed to be comparable between cytology and endoscopy, whereas autoantibody and microRNAs bear potential as future noninvasive screening tools for ESCC. To reduce ESCC-related death in high-risk populations, it is important to develop a more accurate and less-invasive screening test.
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Affiliation(s)
- Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China; School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China; Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Yunyang Deng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yijun Bai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Harry H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China; General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Scotland, UK
| | - Jinqiu Yuan
- Clinical Research Centre, Scientific Research Centre, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Lin Zhang
- School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hon Chi Yip
- Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Philip Wai Yan Chiu
- Department of Surgery, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
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25
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Shahrokh S, Salmanian S, Foroughi A, Shahin M. Successful treatment of recurrent esophageal squamous cell carcinoma with muscle metastasis using capecitabine and cetuximab. Proc (Bayl Univ Med Cent) 2022; 35:834-836. [DOI: 10.1080/08998280.2022.2101155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Affiliation(s)
- Soroush Shahrokh
- Internal Medicine Residency Program, University of Houston College of Medicine/HCA Houston Healthcare – Kingwood, Houston, Texas
| | - Soraya Salmanian
- Onco-Pathology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Foroughi
- Department of Radiation Oncology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohadese Shahin
- Department of Radiation Oncology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Zhang RY, Zhu SJ, Xue P, He SQ. Cutaneous metastasis from esophageal squamous cell carcinoma: A case report. World J Clin Cases 2022; 10:4676-4683. [PMID: 35663085 PMCID: PMC9125271 DOI: 10.12998/wjcc.v10.i14.4676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/27/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Esophageal cancer is a common cause of cancer-related death worldwide. Cutaneous metastasis of esophageal squamous cell carcinoma is rare, particularly in diffuse skin metastasis. CASE SUMMARY In this case report, we describe an 82-year-old male who was diagnosed with esophageal squamous cell carcinoma. The tumor was staged as T4N3M1 (Stage IVB). The pathological findings revealed poorly differentiated squamous cell carcinoma of the esophagus. Four months after diagnosis, the patient began chemotherapy, and symptoms were relieved after four cycles of chemotherapy. After that, the patient returned home without a systematic physical examination. One year after diagnosis, the patient realized that the skin of the abdominal wall was hard and rough without pain, and the color became darker than normal skin. Thirteen months after diagnosis, a biopsy of the patient's abdominal lesion revealed that the skin metastasis was derived from the esophagus. Then the patient received two cycles of apatinib combined with docetaxel, but the abdominal lesion worsened. Two cycles of nivolumab were administered, but the patient eventually died of multiple organ failure. CONCLUSION This report highlights cutaneous metastasis as a late and untreatable metastasis of esophageal cancer.
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Affiliation(s)
- Rui-Yan Zhang
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medicine Sciences, Beijing 100102, China
| | - Shi-Jie Zhu
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medicine Sciences, Beijing 100102, China
| | - Peng Xue
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medicine Sciences, Beijing 100102, China
| | - Sheng-Qi He
- Department of Oncology, Wangjing Hospital, China Academy of Chinese Medicine Sciences, Beijing 100102, China
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Aledavood SA, Akbari Oryani M, Pishevar Feizabad Z. Tongue metastasis originated from esophageal squamous cell carcinoma: A case report. Clin Case Rep 2022; 10:e05648. [PMID: 35414926 PMCID: PMC8980896 DOI: 10.1002/ccr3.5648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/03/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022] Open
Abstract
The tongue is a rare site for metastasis. In this report, we present a woman with a history of esophageal squamous cell carcinoma who suffered from two metastatic masses on the left side of her tongue 2 years after completion of definitive chemoradiation. The patient underwent chemotherapy and left hemi‐glossectomy.
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Affiliation(s)
| | - Mahsa Akbari Oryani
- Department of Pathology, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Zohreh Pishevar Feizabad
- Student Research Committee, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
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28
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Xia L, Liang W, Que D, Xie Q. Correlation Analysis of circRNA Circ_0071662 in Diagnosis and Prognosis of Esophageal Squamous Cell Carcinoma. Int J Gen Med 2022; 14:10423-10428. [PMID: 35002298 PMCID: PMC8721522 DOI: 10.2147/ijgm.s343889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/12/2021] [Indexed: 01/10/2023] Open
Abstract
Background The role of circRNA circ_0071662 has been studied in bladder cancer. The present study aimed to analyze its involvement in esophageal squamous cell carcinoma (ESCC). Methods Patients with ESCC (n = 66), esophageal ulcer (EU, n = 66), or gastroesophageal reflux disease (GERD, n = 66) and healthy controls (n = 66) were enrolled in this study. Plasma samples were collected from all patients and controls. ESCC and paired non-tumor tissue samples were collected from ESCC patients. Circ_0071662 levels in these samples were determined by RT-qPCRs. Diagnostic and prognostic values of circ_0071662 for ESCC were analyzed with ROC curve and survival curve analyses. Results Circ_0071662 level was decreased in ESCC, but not in GERN and EU compared to the controls and in ESCC tissues compared to the non-tumor tissues. Plasma circ_0071662 was closely correlated with patients’ tumor size but not with other clinical features. Decreased plasma circ_0071662 levels separated ESCC patients from GERN patients, EU patients, and healthy controls. Low plasma circ_0071662 levels were closely correlated with worse survival outcomes of ESCC patients. Conclusion Circ_0071662 is lowly expressed in ESCC and may serve as a potential diagnostic and prognostic biomarker for ESCC.
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Affiliation(s)
- Lei Xia
- Cancer Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing City, 400000, People's Republic of China
| | - Wei Liang
- Department of Oncology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing City, 400000, People's Republic of China
| | - Dan Que
- Department of Oncology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing City, 400000, People's Republic of China
| | - Qichao Xie
- Department of Oncology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing City, 400000, People's Republic of China
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29
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Solitary lower limb cutaneous metastasis in a case of esophageal adenocarcinoma: a rare presentation. Int Cancer Conf J 2022; 11:109-113. [PMID: 35402136 PMCID: PMC8938559 DOI: 10.1007/s13691-021-00532-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/27/2021] [Indexed: 01/09/2023] Open
Abstract
Esophageal cancer is the ninth most common cancer all over the world and is sixth in the list of cancer-related mortality. Here in this report, we present an elderly male with solitary subcutaneous metastasis to right thigh 2 years following esophagectomy for esophageal adenocarcinoma. Operative notes revealed inadequate margins on frozen section analysis during initial resection, which were subsequently revised. Postoperative histopathology showed ypT3N0M0 Grade 3 mucin-secreting adenocarcinoma. A wedge biopsy from the thigh growth revealed metastatic mucinous adenocarcinoma. Positron Emission Tomography (PET) was done, which showed a higher tracer uptake in the ulcero-proliferative lesion arising from the subcutaneous plane in the right thigh with no evidence of any other metastasis or recurrence at the primary site. As the reported incidence of distant unexpected metastases is growing, careful physical examination with a preoperative PET-CT is indispensable. Further knowledge on options on treatment of such isolated cutaneous metastasis needs to be studied by the scientific community.
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A Case of Esophageal Squamous Cell Carcinoma Metastasized to the Colonic Anastomotic Site of Right Hemicolectomy. ACG Case Rep J 2022; 9:e00733. [PMID: 35083362 PMCID: PMC8785934 DOI: 10.14309/crj.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
A 73-year-old woman with a history of right hemicolectomy for advanced ascending colon cancer 14 years earlier was referred to our facility for a 2-month history of solid food dysphagia. An esophagogastroduodenoscopy revealed a 7-cm fungating and ulcerated mass in the middle to lower esophagus. The biopsy from the esophageal mass showed a moderately to poorly differentiated squamous cell carcinoma. A colonoscopy showed an end-to-end ileocolonic anastomosis with a 7-mm ulceration in the transverse colon. The biopsy of the ulceration at the anastomotic site showed a moderately to poorly differentiated squamous cell carcinoma with a morphology similar to that of the esophageal mass, rendering the diagnosis of metastatic esophageal squamous cell carcinoma. Colonic metastasis from esophageal squamous cell carcinoma, especially at the anastomotic site, is extremely rare. Although surgical trauma may not have contributed to the anastomotic site metastasis, given the distant timeline, its role in the pathogenesis of metastasis cannot be completely ruled out.
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31
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Liu S, Dreher PC, Belkoff L, Cahn DB. Metastatic esophageal cancer presenting as bladder mass, a case report. Urol Case Rep 2021; 40:101790. [PMID: 34849343 PMCID: PMC8608591 DOI: 10.1016/j.eucr.2021.101790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022] Open
Abstract
Metastatic esophageal cancer to urinary bladder is extremely rare and presents as an extremely poor prognosis. Herein, we describe the case of a 68 year-old female with history of resected adenocarcinoma of gastroesophageal junction in remission, who presented with gross hematuria and a bladder lesion. The patient underwent resection of the mass with final pathology consistent with metastatic adenocarcinoma of gastroesophageal junction.
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Affiliation(s)
- Stephanie Liu
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | | | - David B Cahn
- Main Line Health, Department of Urology, Bryn Mawr, PA, USA
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32
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João M, Brito D, Garcia H, Alves S. An unexpected location for a metastasis from oesophageal squamous carcinoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 114:234-235. [PMID: 34844414 DOI: 10.17235/reed.2021.8467/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We report the case of a 69-year-old man with a relevant alcohol consumption and history of prostate cancer performed a screening upper gastrointestinal endoscopy and colonoscopy. The upper gastrointestinal endoscopy revealed an ulcerated mass in the middle oesophagus occupying half the circumference. Histologic examination was compatible with a squamous cell carcinoma. Staging with endoscopic ultrasound and computed tomography of the neck, chest, and abdomen was consistent with a T3N1M0.
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Affiliation(s)
- Mafalda João
- Gastroenterology, Instituto Português de Oncologia de Coimbra, Portugal
| | - Daniel Brito
- Gastroenterology, Instituto Português de Oncologia de Coimbra
| | | | - Susana Alves
- Gastroenterology, Instituto Português de Oncologia de Coimbra
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33
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Link B, Torres Crigna A, Hölzel M, Giordano FA, Golubnitschaja O. Abscopal Effects in Metastatic Cancer: Is a Predictive Approach Possible to Improve Individual Outcomes? J Clin Med 2021; 10:5124. [PMID: 34768644 PMCID: PMC8584726 DOI: 10.3390/jcm10215124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/20/2021] [Accepted: 10/29/2021] [Indexed: 02/07/2023] Open
Abstract
Patients with metastatic cancers often require radiotherapy (RT) as a palliative therapy for cancer pain. RT can, however, also induce systemic antitumor effects outside of the irradiated field (abscopal effects) in various cancer entities. The occurrence of the abscopal effect is associated with a specific immunological activation in response to RT-induced cell death, which is mainly seen under concomitant immune checkpoint blockade. Even if the number of reported apscopal effects has increased since the introduction of immune checkpoint inhibition, its occurrence is still considered rare and unpredictable. The cases reported so far may nevertheless allow for identifying first biomarkers and clinical patterns. We here review biomarkers that may be helpful to predict the occurrence of abscopal effects and hence to optimize therapy for patients with metastatic cancers.
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Affiliation(s)
- Barbara Link
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany; (B.L.); (A.T.C.); (F.A.G.)
| | - Adriana Torres Crigna
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany; (B.L.); (A.T.C.); (F.A.G.)
| | - Michael Hölzel
- Institute of Experimental Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany;
| | - Frank A. Giordano
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany; (B.L.); (A.T.C.); (F.A.G.)
| | - Olga Golubnitschaja
- Predictive, Preventive, Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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34
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Zhao Z, Yang S, Zhou A, Li X, Fang R, Zhang S, Zhao G, Li P. Small Extracellular Vesicles in the Development, Diagnosis, and Possible Therapeutic Application of Esophageal Squamous Cell Carcinoma. Front Oncol 2021; 11:732702. [PMID: 34527593 PMCID: PMC8435888 DOI: 10.3389/fonc.2021.732702] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/09/2021] [Indexed: 12/14/2022] Open
Abstract
Esophageal squamous cell carcinoma (ESCC) persists among the most lethal and broad-spreading malignancies in China. The exosome is a kind of extracellular vesicle (EV) from about 30 to 200 nm in diameter, contributing to the transfer of specific functional molecules, such as metabolites, proteins, lipids, and nucleic acids. The paramount role of exosomes in the formation and development of ESCC, which relies on promoting intercellular communication in the tumor microenvironment (TME), is manifested with immense amounts. Tumor-derived exosomes (TDEs) participate in most hallmarks of ESCC, including tumorigenesis, invasion, angiogenesis, immunologic escape, metastasis, radioresistance, and chemoresistance. Published reports have delineated that exosome-encapsulated cargos like miRNAs may have utility in the diagnosis, as prognostic biomarkers, and in the treatment of ESCC. This review summarizes the function of exosomes in the neoplasia, progression, and metastasis of ESCC, which improves our understanding of the etiology and pathogenesis of ESCC, and presents a promising target for early diagnostics in ESCC. However, recent studies of exosomes in the treatment of ESCC are sparse. Thus, we introduce the advances in exosome-based methods and indicate the possible applications for ESCC therapy in the future.
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Affiliation(s)
- Zheng Zhao
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuyue Yang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Anni Zhou
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Rui Fang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shutian Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guiping Zhao
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peng Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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35
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Schizas D, Vailas M, Sotiropoulou M, A Ziogas I, S Mylonas K, Katsaros I, Kapelouzou A, Liakakos T. Surgery for metachronous oligometastatic esophageal cancer: Is there enough evidence? Cir Esp 2021; 99:490-499. [PMID: 34353590 DOI: 10.1016/j.cireng.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023]
Abstract
Esophageal cancer is the sixth most common cause of cancer-related mortality worldwide. Despite advances in diagnostic modalities and treatment options, five-year survival rates are below 20%. Esophagectomy with extended lymph node dissection is the mainstay of treatment. More than 50% of patients experience recurrence within 1-3 years postoperatively. Recurrent disease may present locoregionally at the site of anastomosis or as recurrence through lymphatic spread in lymph node basins, as hematogenic metastasis, or as a combination of these. The standard treatment of recurrence is currently predicated on systemic chemotherapy and/or radiotherapy. Recent evidence suggests that surgical treatment of metachronous oligometastatic disease may be prognostically advantageous over medical management alone. Given the considerably low response rates to chemoradiotherapy, many institutions have adopted surgical treatment strategies for oligo-recurrent disease on a case-by-case basis. The aim of this article is to review the current evidence on the role of surgical treatment for metachronous oligometastases from esophageal cancer.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Michail Vailas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece.
| | - Maria Sotiropoulou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis A Ziogas
- Department of Surgery, Vanderbilt University Medical Center, 1313 21st Avenue South, Nashville, TN, USA
| | - Konstantinos S Mylonas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis Katsaros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Alkistis Kapelouzou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Theodore Liakakos
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
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Jindal T, Sarwal A, Pawar P, Dhanalakshmi M, Subedi N. Laparoscopic management of isolated metachronous adrenal metastases in a patient with esophageal cancer: a case report. J Med Case Rep 2021; 15:369. [PMID: 34253234 PMCID: PMC8276374 DOI: 10.1186/s13256-021-02849-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 04/04/2021] [Indexed: 12/05/2022] Open
Abstract
Background The presence of isolated metachronous adrenal metastasis in patients with esophageal cancer is rare. There is significant controversy regarding the management of such patients. Adrenal metastasectomy has been shown to be of benefit in some reports. Minimally invasive approach, although the gold standard for adrenalectomy, has not been used commonly in a postesophagectomy setting owing to the anticipated technical difficulties. We describe one such case wherein this approach helped in early recovery and long-term survival. Case presentation A 59-year-old male of Asian ethnicity presented with an isolated left adrenal nodule, 3 years after an Ivor Lewis esophagectomy for a lower esophageal adenocarcinoma. The biopsy of the nodule was suggestive of metastatic adenocarcinoma. The patient underwent laparoscopic excision of the left adrenal gland. Conclusion Adrenal metastasectomy, in postesophagectomy patients can provide good oncological control. Laparoscopic approach, though technically challenging, can provide results equivalent to those of open surgery, albeit with less morbidity.
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Affiliation(s)
- Tarun Jindal
- Department of Uro-oncology, Tata Medical Centre, Kolkata, India
| | - Ankush Sarwal
- Department of Uro-oncology, Tata Medical Centre, Kolkata, India
| | - Pravin Pawar
- Department of Uro-oncology, Tata Medical Centre, Kolkata, India
| | - M Dhanalakshmi
- Department of Uro-oncology, Tata Medical Centre, Kolkata, India
| | - Neeraj Subedi
- Department of Urology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal.
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37
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Suzuki H, Abe T, Sasaki E, Nagao T, Murashima A, Fujieda H, Higaki E, Hanai N. Synchronous Resection of Parotid Metastasis With Esophagectomy: A Case Report. In Vivo 2021; 35:2337-2340. [PMID: 34182515 DOI: 10.21873/invivo.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Preoperative diagnosis of parotid tumor is mainly performed via imaging and cytology to avoid both facial nerve injury and tumor seeding. Synchronous resection of solitary parotid metastasis with esophagectomy for esophageal squamous cell carcinoma is rarely performed. CASE REPORT This is a case report of a 58-year-old male patient with a left preauricular tumor, which was cytologically diagnosed as squamous cell carcinoma. Esophageal squamous cell carcinoma was pathologically diagnosed following 18F-fluorodeoxyglucose positron emission tomography with computed tomography. His diagnosis was cT2N0M0 esophageal squamous cell carcinoma with cT3N0M0 parotid carcinoma. Esophagectomy for esophageal cancer, as well as parotidectomy were performed. Pathological diagnosis of pT1bN1M1 (parotid) esophageal squamous cell carcinoma was based on exclusion diagnosis of no primary tumor from several specialists and pathological findings including immunohistochemical staining. CONCLUSION Reporting of more cases of rare synchronous metastasectomy and esophagectomy is needed to clarify treatment strategies.
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Affiliation(s)
- Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan;
| | - Tetsuya Abe
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Eiichi Sasaki
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takuya Nagao
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Akihiro Murashima
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hironori Fujieda
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Eiji Higaki
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
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Wang Y, Niu Z, Zhou L, Zhou Y, Ma Q, Zhu Y, Liu M, Shi Y, Tai Y, Shao Q, Ge J, Hua J, Gao L, Huang H, Jiang H, Sun Q. Subtype-Based Analysis of Cell-in-Cell Structures in Esophageal Squamous Cell Carcinoma. Front Oncol 2021; 11:670051. [PMID: 34178655 PMCID: PMC8231019 DOI: 10.3389/fonc.2021.670051] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/19/2021] [Indexed: 11/29/2022] Open
Abstract
Cell-in-cell (CIC) structures are defined as the special structures with one or more cells enclosed inside another one. Increasing data indicated that CIC structures were functional surrogates of complicated cell behaviors and prognosis predictor in heterogeneous cancers. However, the CIC structure profiling and its prognostic value have not been reported in human esophageal squamous cell Carcinoma (ESCC). We conducted the analysis of subtyped CIC-based profiling in ESCC using "epithelium-macrophage-leukocyte" (EML) multiplex staining and examined the prognostic value of CIC structure profiling through Kaplan-Meier plotting and Cox regression model. Totally, five CIC structure subtypes were identified in ESCC tissue and the majority of them was homotypic CIC (hoCIC) with tumor cells inside tumor cells (TiT). By univariate and multivariate analyses, TiT was shown to be an independent prognostic factor for resectable ESCC, and patients with higher density of TiT tended to have longer post-operational survival time. Furthermore, in subpopulation analysis stratified by TNM stage, high TiT density was associated with longer overall survival (OS) in patients of TNM stages III and IV as compared with patients with low TiT density (mean OS: 51 vs 15 months, P = 0.04) and T3 stage (mean OS: 57 vs 17 months, P=0.024). Together, we reported the first CIC structure profiling in ESCC and explored the prognostic value of subtyped CIC structures, which supported the notion that functional pathology with CIC structure profiling is an emerging prognostic factor for human cancers, such as ESCC.
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Affiliation(s)
- Yuqi Wang
- College of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
- Research Unit of Cell Death Mechanism, Institute of Biotechnology, Chinese Academy of Medical Science, Beijing, China
| | - Zubiao Niu
- Research Unit of Cell Death Mechanism, Institute of Biotechnology, Chinese Academy of Medical Science, Beijing, China
| | - Lulin Zhou
- Research Unit of Cell Death Mechanism, Institute of Biotechnology, Chinese Academy of Medical Science, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Yongan Zhou
- Department of Thoracic Surgery, The Second Affiliated Hospital of Air Force Military Medical University, Xi’an, China
| | - Qunfeng Ma
- Department of Thoracic Surgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yichao Zhu
- Research Unit of Cell Death Mechanism, Institute of Biotechnology, Chinese Academy of Medical Science, Beijing, China
| | - Mengzhe Liu
- College of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
| | - Yinan Shi
- College of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanhong Tai
- Department of Pathology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qiuju Shao
- Department of Radiotherapy, The Second Affiliated Hospital of Air Force Military Medical University, Xi’an, China
| | - Jianlin Ge
- College of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
| | - Jilei Hua
- College of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
| | - Lihua Gao
- Research Unit of Cell Death Mechanism, Institute of Biotechnology, Chinese Academy of Medical Science, Beijing, China
| | - Hongyan Huang
- Department of Oncology, Beijing Shijitan Hospital of Capital Medical University, Beijing, China
| | - Hong Jiang
- College of Life Science and Bioengineering, School of Science, Beijing Jiaotong University, Beijing, China
| | - Qiang Sun
- Research Unit of Cell Death Mechanism, Institute of Biotechnology, Chinese Academy of Medical Science, Beijing, China
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ECM Remodeling in Squamous Cell Carcinoma of the Aerodigestive Tract: Pathways for Cancer Dissemination and Emerging Biomarkers. Cancers (Basel) 2021. [DOI: 10.3390/cancers13112759
expr 955442319 + 839973387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Squamous cell carcinomas (SCC) include a number of different types of tumors developing in the skin, in hollow organs, as well as the upper aerodigestive tract (UADT) including the head and neck region and the esophagus which will be dealt with in this review. These tumors are often refractory to current therapeutic approaches with poor patient outcome. The most important prognostic determinant of SCC tumors is the presence of distant metastasis, significantly correlating with low patient survival rates. Rapidly emerging evidence indicate that the extracellular matrix (ECM) composition and remodeling profoundly affect SSC metastatic dissemination. In this review, we will summarize the current knowledge on the role of ECM and its remodeling enzymes in affecting the growth and dissemination of UADT SCC. Taken together, these published evidence suggest that a thorough analysis of the ECM composition in the UADT SCC microenvironment may help disclosing the mechanism of resistance to the treatments and help defining possible targets for clinical intervention.
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ECM Remodeling in Squamous Cell Carcinoma of the Aerodigestive Tract: Pathways for Cancer Dissemination and Emerging Biomarkers. Cancers (Basel) 2021; 13:cancers13112759. [PMID: 34199373 PMCID: PMC8199582 DOI: 10.3390/cancers13112759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Local and distant metastasis of patients affected by squamous cell carcinoma of the upper aerodigestive tract predicts poor prognosis. In the latest years, the introduction of new therapeutic approaches, including targeted and immune therapies, has improved the overall survival. However, a large number of these patients do not benefit from these treatments. Thus, the identification of suitable prognostic and predictive biomarkers, as well as the discovery of new therapeutic targets have emerged as a crucial clinical need. In this context, the extracellular matrix represents a suitable target for the development of such therapeutic tools. In fact, the extracellular matrix is composed by complex molecules able to interact with a plethora of receptors and growth factors, thus modulating the dynamic crosstalk between cancer cells and the tumor microenvironment. In this review, we summarize the current knowledge of the role of the extracellular matrix in affecting squamous cell carcinoma growth and dissemination. Despite extracellular matrix is known to affect the development of many cancer types, only a restricted number of these molecules have been recognized to impact on squamous cell carcinoma progression. Thus, we consider that a thorough analysis of these molecules may be key to develop new potential therapeutic targets/biomarkers. Abstract Squamous cell carcinomas (SCC) include a number of different types of tumors developing in the skin, in hollow organs, as well as the upper aerodigestive tract (UADT) including the head and neck region and the esophagus which will be dealt with in this review. These tumors are often refractory to current therapeutic approaches with poor patient outcome. The most important prognostic determinant of SCC tumors is the presence of distant metastasis, significantly correlating with low patient survival rates. Rapidly emerging evidence indicate that the extracellular matrix (ECM) composition and remodeling profoundly affect SSC metastatic dissemination. In this review, we will summarize the current knowledge on the role of ECM and its remodeling enzymes in affecting the growth and dissemination of UADT SCC. Taken together, these published evidence suggest that a thorough analysis of the ECM composition in the UADT SCC microenvironment may help disclosing the mechanism of resistance to the treatments and help defining possible targets for clinical intervention.
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Schizas D, Vailas M, Sotiropoulou M, A Ziogas I, S Mylonas K, Katsaros I, Kapelouzou A, Liakakos T. Surgery for metachronous oligometastatic esophageal cancer: Is there enough evidence? Cir Esp 2021. [PMID: 33894971 DOI: 10.1016/j.ciresp.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Esophageal cancer is the sixth most common cause of cancer-related mortality worldwide. Despite advances in diagnostic modalities and treatment options, five-year survival rates are below 20%. Esophagectomy with extended lymph node dissection is the mainstay of treatment. More than 50% of patients experience recurrence within 1-3 years postoperatively. Recurrent disease may present locoregionally at the site of anastomosis or as recurrence through lymphatic spread in lymph node basins, as hematogenic metastasis, or as a combination of these. The standard treatment of recurrence is currently predicated on systemic chemotherapy and/or radiotherapy. Recent evidence suggests that surgical treatment of metachronous oligometastatic disease may be prognostically advantageous over medical management alone. Given the considerably low response rates to chemoradiotherapy, many institutions have adopted surgical treatment strategies for oligo-recurrent disease on a case-by-case basis. The aim of this article is to review the current evidence on the role of surgical treatment for metachronous oligometastases from esophageal cancer.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Michail Vailas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece.
| | - Maria Sotiropoulou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis A Ziogas
- Department of Surgery, Vanderbilt University Medical Center, 1313 21st Avenue South, Nashville, TN, USA
| | - Konstantinos S Mylonas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis Katsaros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Alkistis Kapelouzou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Theodore Liakakos
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
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Jiao W, Lin C, Xiao L, Zhang X, Hu M, Zhao M, Wang J. Clinicopathological Features and Prognoses in Patients With Brain Metastases From Small-Cell Esophageal Carcinoma: A Retrospective Analysis of 18 Patients. Front Oncol 2021; 11:654727. [PMID: 33937062 PMCID: PMC8085384 DOI: 10.3389/fonc.2021.654727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aims to examine the clinical characteristics of patients with brain metastases (BM) from small-cell esophageal carcinoma (SCEC) and to explore the association of the corresponding factors with overall survival (OS). Methods: The data of 18 patients with brain metastases from SCEC, diagnosed from January 1, 2006, to December 31, 2018, in the Fourth Hospital of Hebei Medical University were analyzed retrospectively. Results: The 18 patients who were included in this study accounted for 6.7% of the patients with SCEC diagnosed from 2006 to 2018. Of the 18 patients, 8 (44.4%) were females. For the entire cohort, the median OS was 7 months, the 1-year OS was 22.2%, and the 2-year OS was 0%. For patients who received whole-brain radiotherapy (WBRT) and for those who did not (13 vs. 5), the median OS was 11.9 and 3 months, respectively, and the 1-year OS was 30.8 and 0%, respectively. When comparing diagnosis-specific Graded Prognostic Assessment (DS-GPA) scores of patients with BM from SCEC ranging from 2.5 to 4 and from 0 to 2, the median OS was 13.1 and 4 months, respectively, and the 1-year OS was 57.1 and 0%, respectively. In the univariable regression, patients who received WBRT had improved OS compared to those who did not (HR = 0.249, p = 0.018), and patients with a DS-GPA score of 2.5–4 were associated with improved OS compared with patients with a DS-GPA score of 0–2 (HR = 0.050, p = 0.005). Conclusion: The incidence of brain metastases in patients with SCEC is low, but the prognosis in those patients is very poor. The DS-GPA score may be a prognostic factor of patients with BM from SCEC. Brain radiotherapy could improve the survival of these patients.
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Affiliation(s)
- Wenpeng Jiao
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chi Lin
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Linlin Xiao
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xinyuan Zhang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Mengzhu Hu
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Min Zhao
- Department of Oncology, Hebei Chest Hospital, Shijiazhuang, China
| | - Jun Wang
- Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Wang J, Yu P, Luo J, Sun Z, Yu J, Wang J. Transcriptomic and microRNA Expression Profiles Identify Biomarkers for Predicting Neo-Chemoradiotherapy Response in Esophageal Squamous Cell Carcinomas (ESCC). Front Pharmacol 2021; 12:626972. [PMID: 33935718 PMCID: PMC8082678 DOI: 10.3389/fphar.2021.626972] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/10/2021] [Indexed: 01/01/2023] Open
Abstract
Neo-chemoradiotherapy (nCRT) before surgery is a standard treatment for locally advanced esophageal cancers. However, the treatment outcome of nCRT varied with different patients. This study aimed to identify potential biomarkers for prediction of nCRT-response in patients with esophageal squamous cell carcinoma (ESCC). Microarray datasets of nCRT responder and non-responder samples (access number GSE45670 and GSE59974) of patients with ESCC were downloaded from Gene Expression Omnibus (GEO) database. The mRNA expression profiles of cancer biopsies from four ESCC patients were analyzed before and after nCRT. Differentially expressed genes (DEGs) and miRNAs were screened between nCRT responder and non-responder ESCC samples. Functional enrichment analysis was conducted for these DEGs followed by construction of protein-protein interaction (PPI) network and miRNA-mRNA regulatory network. Finally, univariate survival analysis was performed to identify candidate biomarkers with prognostic values in ESCC. We identified numerous DEGs and differentially expressed miRNAs from nCRT responder group. GO and KEGG analysis showed that the dysregulated genes were mainly involved in biological processes and pathways, including "response to stimulus", "cellular response to organic substance", "regulation of signal transduction", "AGE-RAGE signaling pathway in diabetic complications", and "steroid hormone biosynthesis". After integration of PPI network and miRNA-mRNA network analysis, we found eight genes, TNF, AKR1C1, AKR1C2, ICAM1, GPR68, GNB4, SERPINE1 and MMP12, could be candidate genes associated with disease progression. Univariate cox regression analysis showed that there was no significant correlation between dysregulated miRNAs (such as hsa-miR-34b-3p, hsa-miR-127-5p, hsa-miR-144-3p, and hsa-miR-486-5p, et al.) and overall survival of ESCC patients. Moreover, abnormal expression of MMP12 was significantly correlated with pathological degree, TNM stage, lymph nodes metastasis, and overall survival of ESCC patients (p < 0.05). Taken together, our study identified that MMP12 might be a useful tumor biomarker and therapeutic target for ESCC.
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Affiliation(s)
- Jian Wang
- Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin, China
| | - Pengyi Yu
- Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Jiangsu, China
| | - Judong Luo
- Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Jiangsu, China
| | - Zhiqiang Sun
- Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Jiangsu, China
| | - Jingping Yu
- Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Jiangsu, China
| | - Jianlin Wang
- Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Jiangsu, China
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Betancourt-Cuellar SL, Benveniste MFK, Palacio DP, Hofstetter WL. Esophageal Cancer: Tumor-Node-Metastasis Staging. Radiol Clin North Am 2021; 59:219-229. [PMID: 33551083 DOI: 10.1016/j.rcl.2020.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Esophageal cancer is an uncommon malignancy that ranks sixth in terms of mortality worldwide. Squamous cell carcinoma is the predominant histologic subtype worldwide whereas adenocarcinoma represents the majority of cases in North America, Australia, and Europe. Esophageal cancer is staged using the American Joint Committee on Cancer and the International Union for Cancer Control TNM system and has separate classifications for the clinical, pathologic, and postneoadjuvant pathologic stage groups. The determination of clinical TNM is based on complementary imaging modalities, including esophagogastroduodenoscopy/endoscopic ultrasound; endoscopic ultrasound-fine-needle aspiration; computed tomography of the chest, abdomen, and pelvis; and fluorodeoxyglucose PET/computed tomography.
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Affiliation(s)
- Sonia L Betancourt-Cuellar
- Thoracic Imaging Department, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1478, Houston, TX 77030-4009, USA.
| | - Marcelo F K Benveniste
- Thoracic Imaging Department, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1478, Houston, TX 77030-4009, USA
| | - Diana P Palacio
- Department of Medical Imaging, The University of Arizona - Banner Medical Center, 1501 North Campbell Avenue, PO BOX 245067, Tucson, AZ 85724, USA
| | - Wayne L Hofstetter
- Cardiothoracic Department, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1489, Houston, TX 77030-4009, USA
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Synchronous splenic metastases from squamous cell carcinoma of oesophagus: a case report and review of literature. Clin J Gastroenterol 2021; 14:410-414. [PMID: 33400190 DOI: 10.1007/s12328-020-01321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Synchronous splenic metastases from oesophageal squamous cell carcinomas are extremely rare. Most of the cases of splenic metastases reported in the literature are mainly metachronous and occur usually from adenocarcinoma primary. The treatment options range from splenectomy to palliative chemotherapy with standard doses in fit individuals. However, in cases with poor performance status, the management is often the best supportive care only due to the fear of tolerance and toxicities with standard dose chemotherapy. Herein, we report a case of squamous cell carcinoma of the distal thoracic oesophagus in a poorly fit elderly male diagnosed with synchronous splenic metastases and successfully treated with palliative chemotherapy with reduced flat doses and radiotherapy with no significant toxicities.
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Gironda DJ, Adams DL, He J, Xu T, Gao H, Qiao Y, Komaki R, Reuben JM, Liao Z, Blum-Murphy M, Hofstetter WL, Tang CM, Lin SH. Cancer associated macrophage-like cells and prognosis of esophageal cancer after chemoradiation therapy. J Transl Med 2020; 18:413. [PMID: 33148307 PMCID: PMC7640696 DOI: 10.1186/s12967-020-02563-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer Associated Macrophage-Like cells (CAMLs) are polynucleated circulating stromal cells found in the bloodstream of numerous solid-tumor malignancies. Variations within CAML size have been associated with poorer progression free survival (PFS) and overall survival (OS) in a variety of cancers; however, no study has evaluated their clinical significance in esophageal cancer (EC). METHODS To examine this significance, we ran a 2 year prospective pilot study consisting of newly diagnosed stage I-III EC patients (n = 32) receiving chemoradiotherapy (CRT). CAML sizes were sequentially monitored prior to CRT (BL), ~ 2 weeks into treatment (T1), and at the first available sample after the completion of CRT (T2). RESULTS We found CAMLs in 88% (n = 28/32) of all patient samples throughout the trial, with a sensitivity of 76% (n = 22/29) in pre-treatment screening samples. Improved 2 year PFS and OS was found in patients with CAMLs < 50 μm by the completion of CRT over patients with CAMLs ≥ 50 μm; PFS (HR = 12.0, 95% CI = 2.7-54.1, p = 0.004) and OS (HR = 9.0, 95%CI = 1.9-43.5, p = 0.019). CONCLUSIONS Tracking CAML sizes throughout CRT as a minimally invasive biomarker may serve as a prognostic tool in mapping EC progression, and further studies are warranted to determine if presence of these cells prior to treatment suggest diagnostic value for at-risk populations.
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Affiliation(s)
- Daniel J Gironda
- Rutgers, The State University of New Jersey, 77 Hamilton Street, New Brunswick, NJ, 08901, USA
| | - Daniel L Adams
- Creatv MicroTech Inc, Monmouth Junction, 9 Deer Park Dr, Potomac, NJ, 08852, USA.
| | - Jianzhong He
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Ting Xu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Hui Gao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Yawei Qiao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Ritsuko Komaki
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - James M Reuben
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Mariela Blum-Murphy
- Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Wayne L Hofstetter
- Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Cha-Mei Tang
- Creatv MicroTech Inc, 9900 Belward Campus Dr, Rockville, MD, 20850, USA
| | - Steven H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
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Verstegen MHP, Harker M, Water CVD, Dieren JV, Hugen N, Nagtegaal ID, Rosman C, Post RSVD. Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology. World J Gastroenterol 2020; 26:6037-6046. [PMID: 33132653 PMCID: PMC7584055 DOI: 10.3748/wjg.v26.i39.6037] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Detailed information on metastatic patterns in of patients with esophageal and gastric cancer is limited. Early recognition of metastases is important to avoid futile locoregional treatments. Furthermore, knowledge on metastatic patterns is necessary for further development of personalized treatment modalities.
AIM To gain insight into the metastatic pattern of gastroesophageal cancer.
METHODS A nationwide retrospective autopsy study of 3876 patients with adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the esophagus or stomach between 1990 and 2017 was performed. Only patient with metastases were included for analysis. The metastatic pattern was analyzed according to the primary tumor location and histological subtype.
RESULTS Metastatic disease was found in 268 esophageal and 331 gastric cancer patients. In esophageal cancer, the most common metastatic locations were liver (56%), distant lymph nodes (53%) and lung (50%). Esophageal AC showed more frequently metastases to the peritoneum and bone compared with esophageal SCC. In gastric cancer, the most common metastatic locations were distant lymph nodes (56%), liver (53%) and peritoneum (51%). Intestinal-type AC of the stomach showed metastases to the liver more frequently, whereas metastases to the bone, female reproductive organs and colorectum were observed more frequently in diffuse-type gastric AC.
CONCLUSION This study showed differences in metastatic patterns of patients with esophageal and gastric cancer according to the primary tumor location and histological subtype.
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Affiliation(s)
- Moniek HP Verstegen
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
| | - Mitchell Harker
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
| | - Carlijn van de Water
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
| | - Jolanda van Dieren
- Department of Gastroenterology Oncology, Netherlands Cancer Institute, Amsterdam 1066 CX, Netherlands
| | - Niek Hugen
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
| | - Iris D Nagtegaal
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
| | - Camiel Rosman
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
| | - Rachel S van der Post
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
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Characteristics and Prognostic Factors of Metachronous Second Primary Upper Gastrointestinal Cancer. J Surg Res 2020; 258:254-264. [PMID: 33038603 DOI: 10.1016/j.jss.2020.08.075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Patients with metachronous malignancies before carcinomas of the upper gastrointestinal tract were analyzed regarding clinical parameters, oncological outcome, and prognosis. METHODS We analyzed the data of 1583 patients with gastroesophageal cancer who underwent oncological resections between 2002 and 2018. Of 1583 patients, 172 had a malignant tumor before the upper gastrointestinal cancer (second primary carcinomas) and 1411 without preceding malignancies served as the control group. The analyses were performed between both groups and within the subgroup of second primary carcinomas. RESULTS Patients with second primary carcinomas were older (P < 0.0001), had more comorbidities (P < 0.0001), and underwent longer surgical resections (P = 0.0024). They had lower (y)pT-categories (P = 0.0427) and had longer stays in intensive care unit (P = 0.0002) and hospital (P = 0.0018). R0-resection was more frequent (P = 0.0275) while having more surgical complications (P = 0.0378). The median survival was 39.5 mo (primary carcinoma) versus 32.9 mo for (second primary carcinoma) and was not significantly different (P = 0.5359).In the subgroup analysis of second primaries, there were no significant survival differences depending on primary tumor entity (P = 0.4989). pT status (P = 0.0062), pN status (P < 0.0001), pM status (P < 0.0001), and R-status (P < 0.0001) were significant prognostic factors. A time period >9 y after the primary cancer could be identified as a novel and beneficial survival factor (P = 0.0496). Most patients with primary colorectal, prostate, hematogenous, or breast cancer had adenocarcinoma, whereas patients with initial otolaryngologic cancers mainly had squamous cell carcinoma. CONCLUSIONS Second primary carcinomas of the upper gastrointestinal tract show distinct clinical and oncological characteristics. Common prognostic factors are applicable, and oncologic resection is recommended.
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Rocha BA, Paranaíba LMR, Dantas CD, de Carvalho MGF, de Melo-Filho MR, Lima LMC, Souto GR, Horta MCR. Two rare cases of oral metastasis arising from lung adenocarcinoma and esophageal carcinoma. J Clin Exp Dent 2020; 12:e999-e1004. [PMID: 33154803 PMCID: PMC7600200 DOI: 10.4317/jced.57125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/02/2020] [Indexed: 12/25/2022] Open
Abstract
Metastasis to the oral cavity are rare, representing only 1% of all oral malignancies, and originate from various sites such as the breast, prostate, lung and kidney. Clinically, they can simulate reactive and inflammatory lesions common in the oral cavity, and the clinical and microscopic diagnosis of these metastasis is a challenge. In this article, we report two new cases of esophageal and lung metastasis to oral tissues, highlighting their clinical characteristics and the process of diagnostic elucidation. We emphasize the importance for clinicians to consider the possibility of metastatic lesions in the oral cavity in patients previously diagnosed with malignant lesions in distant tissues and organs. Key words:Diagnosis, esophageal squamous cell carcinoma, adenocarcinoma of lung, oral cavity, metastasis.
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Affiliation(s)
- Breno-Amaral Rocha
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil
| | - Lívia-Maris-Ribeiro Paranaíba
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Ciro-Dantas Dantas
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Sao Paulo, Brazil
| | | | | | | | - Giovanna-Ribeiro Souto
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil
| | - Martinho-Campolina-Rebello Horta
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil
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Zhang N, Liu JF. MicroRNA (MiR)-301a-3p regulates the proliferation of esophageal squamous cells via targeting PTEN. Bioengineered 2020; 11:972-983. [PMID: 32970954 PMCID: PMC8291791 DOI: 10.1080/21655979.2020.1814658] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Human esophageal carcinoma (EC) is a common cancer, which leads to many deaths worldwide every year. Our study aimed to explore the mechanism of miR-301a-3p regulating the proliferation of esophageal squamous cell carcinoma (ESCC) cells. We had collected ESCC tissues and adjacent normal esophageal tissues from 47 patients. The relative levels of miR-301a-3p/U6 in ESCC tissues and cells were analyzed by real-time PCR. And we measured the relative protein levels of PTEN, BCL-2, BAX, and p-AKT/AKT by Western blot. Eca-109 cell proliferation was detected by MTT assay and colony formation. Compared with adjacent normal esophageal tissues, the relative level of miR-301a-3p/U6 was elevated in ESCC tissues. MiR-301a-3p could facilitate ESCC cell proliferation. And miR-301a-3p directly bind to PTEN 3ʹ-UTR and negatively regulated PTEN protein expression. Moreover, silencing PTEN could reversed inhibited proliferation of Eca-109 cells induced by miR-301a-3p inhibitor, while overexpression PTEN could reversed enhanced proliferation of Eca-109 cells induced by miR-301a-3p mimic. Taken together, miR-301a-3p promoted ESCC cell proliferation by supressing PTEN.
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Affiliation(s)
- Nan Zhang
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China
| | - Jun Feng Liu
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China
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