Abstract
BackgroundSolitary pulmonary metastasis from esophageal basaloid squamous cell carcinoma (BSCC) components is an extremely rare recurrence of esophageal squamous cell carcinoma (SCC).Case presentationA 68-year-old Japanese woman was found to have a suspected malignant mass, approximately 2 cm in diameter, in her left lower pulmonary lobe, at 66 months after undergoing a curative esophagectomy with three-field lymph node dissection for esophageal SCC with a focal basaloid component. After a CT-guided biopsy, pathological examination indicated a metastasis from esophageal BSCC components. She underwent a thoracoscopic partial resection of the left lower pulmonary lobe for the solitary pulmonary metastasis. The pathohistology of the resected specimen led to diagnosis of metastatic esophageal BSCC, which showed immunohistochemical findings similar to those of the primary esophageal carcinoma. The patient received two courses of adjuvant chemotherapy (5-fluorouracil, docetaxel plus nedaplatin) and recovered to resume a normal life with maintenance therapy. However, multiple lung and brain metastases were diagnosed at 2 years after the pulmonary metastasectomy. She survived 5 years and 6 months after the pulmonary metastasectomy, but died at 10 years and 6 months after her initial esophagectomy.ConclusionThis was a rare surgical resected case of solitary pulmonary metastasis from esophageal BSCC components.
Highlights
Resection of solitary metastases to the lung from various primary malignancies, such as colorectal cancer and head and neck cancer, in the absence of other metastases, is reportedly becoming the standard therapy [1, 2]
We described a successful pulmonary metastasectomy for a solitary pulmonary metastasis from esophageal SCC that was primarily composed of basaloid squamous cell carcinoma (BSCC) components
Metastases from esophageal SCC are most commonly diagnosed in lymph nodes (45%) followed by liver (35%), Fig. 3 a Macroscopic observation of the resected left lung specimen shows a white nodule with irregular borders. b Histological evaluation of the pulmonary lesion, leading to diagnosis of metastasis of basaloid squamous cell carcinoma of the esophagus with deposition of hyaline-like material
Summary
Resection of solitary metastases to the lung from various primary malignancies, such as colorectal cancer and head and neck cancer, in the absence of other metastases, is reportedly becoming the standard therapy [1, 2]. Some of the tumor nests exhibited ambiguous nuclear palisading arrangement in the peripheral region, in which deposition of hyaline-like materials was occasionally identified. These histological features were diagnostic of moderately differentiated SCC with a focal basaloid component. Routine follow-up chest xrays and computed tomography (CT) scans showed no masses in the lungs or other abnormalities for more than 5 years after adjuvant chemotherapies. She never complained of gastrointestinal or pulmonary symptoms. The immunohistochemical examination indicated that the tumor had metastasized from the primary
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