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Primary esophageal adenocarcinoma with distant metastasis to the skeletal muscle.
[esophageal adenocarcinoma]
Abstract
Hematogenous
metastasis
of
esophageal
adenocarcinoma
to
the
skeletal
muscle
is
uncommon
.
We
report
a
rare
case
of
esophageal
adenocarcinoma
with
metastasis
to
the
skeletal
muscle
.
During
pretherapeutic
examination
,
a
painful
mass
was
detected
in
the
left
thigh
of
a
49
-
year
-old
man
.
Endoscopic
biopsy
identified
poorly
differentiated
,
advanced
esophageal
adenocarcinoma
.
Computed
tomography
(
CT
)
revealed
wall
thickening
in
the
distal
esophagus
.
Two
enlarged
lymph
nodes
were
detected-the
middle
thoracic
paraesophageal
lymph
node
in
the
mediastinum
and
the
right
cardiac
lymph
node
.
(
18
)
F-
fluorodeoxyglucose
(
FDG
)
positron
emission
tomography
demonstrated
left
thigh
metastasis
,
which
had
not
been
detected
by
CT
3
weeks
previously
,
with
increased
accumulation
of
FDG
.
Therefore
,
ultrasound-guided
core-needle
biopsy
was
performed
.
Histologic
and
immunohistochemical
findings
supported
a
diagnosis
of
poorly
differentiated
adenocarcinoma
.
The
final
diagnosis
was
primary
esophageal
adenocarcinoma
with
distant
metastasis
to
the
skeletal
(
left
thigh
)
muscle
.
The
rate
of
disease
progression
in
this
case
emphasizes
the
malignant
potential
of
esophageal
adenocarcinoma
.
A
few
cases
of
skeletal
metastasis
from
advanced
esophageal
adenocarcinoma
have
been
previously
reported
.
However
,
rapid
metastasis
to
a
distant
skeletal
muscle
with
no
other
hematogenous
metastasis
is
quite
rare
.
Early
detection
and
rapid
treatment
are
especially
important
in
cases
of
esophageal
adenocarcinoma
.