A Case of Small Intestinal Metastasis from Esophageal Squamous Cell Carcinoma

Osamu Shimooki, Yuko Baba, Toru Yoshida, Tadashi Abe, Noriyuki Uesugi^*and Shin-ichi Nakamura^*

Department of Surgery, Iwate Prefectural Kuji Hospital
Division of Pathology, Central Clinical Laboratory, School of Medicine, Iwate Medical University^*

We describe a case of squamous cell carcinoma of the esophagus with a solitary metastasis to the small bowel causing small bowel obstruction. A 63-year-old man admitted with dysphagia was diagnosed with lower thoracic esophageal cancer (T3N1M0 Stage III). Esophagectomy was contraindicated due to invasion to the aorta and diaphragm and metastasis to the liver. Enterostomy for nutrition was implemented followed by chemo-radiotherapy. Obstructed bowel symptoms developed on postoperative day (POD) 50. On POD 87, an operation was conducted for ileus. Stricture of the ileum was recognized 50 cm orally from the ileal ending, necessitating partial resection of the ileum, including the stricture. The histopathological diagnosis was ileal metastasis from esophageal cancer. Metastasis to the small bowel from esophageal cancer is very rare, with our case only the fifth reported in the international literature.

Key words
squamous cell carcinoma of esophagus, solitary metastatic tumor of small bowel, small bowel obstruction

Reprint requests
Osamu Shimooki Department of Surgery, Iwate Prefectural Kuji Hospital 10-1 Asahicho, Kuji city, 028-8040 JAPAN

Accepted
May 27, 2003

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