Adenocarcinoma of the Esophagus Metastasized from the Lung -A Case Report

Satoshi Ishiyama, Yousuke Izumi, Tomoko Hanashi* and Misao Yoshida**

Department of Surgery, Tokyo Metropolitan Komagome Hospital
Department of Surgery, Tokai University Tokyo Hospital*
Tokyo Metropolitan Bokutoh Hospital**

A 80-year-old woman admitted with progressive dysphasia and weight loss was found in computed tomography to have a pulmonary tumor with pleural indentation in the left lower lobe. Bronchoalveolar lavage (BAL) of the lesion led to a cytological diagnosis of adenocarcinoma. Barium and endoscopy showed a circumferential stricture without mucosal abnormality in the middle third of the esophagus. Cytological studies on specimens by fine needle aspiration biopsy under endoscopic ultrasonography (EUS-FNAB) defined adenocarcinoma similar to cytological findings in the BAL specimen. These facts strongly suggested that the esophageal tumor had metastasized from the lung. She was diagnosed with Stage IV lung cancer. Because of her age and poor renal and respiratory function, she underwent esophageal stenting. Distant metastasis in lung cancer is rare in the esophagus, with only 19 cases including ours, reported thus far in Japanese literatures. The dismal prognosis makes the flexible metallic stent a good treatment option for such patients.

Key words
esophageal metastasis, lung cancer, fine needle aspiration biopsy

Reprint requests
Satoshi Ishiyama Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishi-Shinbashi, Minato-ku, 105-8461 JAPAN

Accepted
December 17, 2004

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