Abstract
Background: Esophageal squamous cell carcinoma with distant metastasis is not uncommon. It is quite infrequent that esophageal squamous cell carcinoma presents with abscess-like skeletal muscle metastasis. We report a case with such rare clinical presentation and emphasize the importance of clinical suspicion which may lead to a different treatment plan. Case Report: A 75-year-old man who has a stage Ⅲ esophageal squamous cell carcinoma presented to our hospital with progressive pain and swelling of his left hip and thigh. Computed tomography (CT) showed loculated fluid collections in the left gluteus and thigh regions and destruction of the left iliac crest. Bone scan study showed increased radioisotope uptake at the left anterior ilium. For the suspicion of abscess formation, fasciotomy was done. However, serosanguinous fluid accumulation and tensor fascia lata necrosis were noted instead of abscesses. Biopsy of the soft tissue showed metastatic squamous cell carcinoma. Conclusion: We should always keep in mind that an abscess-like fluid accumulation may be the manifestation of a primary or metastatic malignancy. Diagnosis should be made vigilantly because the staging and treatment protocol can be totally different.
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