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Esophageal squamous cell carcinoma with dural and bone marrow metastases.
[esophageal squamous cell carcinoma]
Patients
with
esophageal
squamous
cell
carcinoma
generally
present
at
an
advanced
stage
at
the
time
of
diagnosis
.
The
most
common
sites
of
visceral
metastasis
are
the
lung
,
liver
and
bone
,
but
brain
and
bone
marrow
involvement
is
exceedingly
rare
.
Herein
,
we
report
a
62
-
year
-old
man
with
a
4
-
wk
history
of
progressive
low
back
pain
with
radiation
to
bilateral
lower
legs
,
dysphagia
and
body
weight
loss
.
Esophageal
squamous
cell
carcinoma
with
regional
lymph
node
,
liver
and
bone
metastases
was
diagnosed
.
He
underwent
concurrent
chemoradiotherapy
and
got
a
partial
response
.
Four
months
later
,
he
complained
of
headache
,
diplopia
and
severe
hearing
impairment
in
the
left
ear
.
There
was
no
evidence
for
bacterial
,
fungal
,
tuberculous
infection
or
neoplastic
infiltration
.
Magnetic
resonance
imaging
of
the
brain
demonstrated
thickening
and
enhancement
of
bilateral
pachymeninges
and
multiple
enhancing
masses
in
bilateral
skull
.
Dural
metastasis
was
diagnosed
and
he
received
whole
brain
irradiation
.
In
addition
,
laboratory
examination
revealed
severe
thrombocytopenia
and
leucopenia
,
and
bone
marrow
study
confirmed
the
diagnosis
of
metastatic
squamous
cell
carcinoma
.
This
is
the
first
described
case
of
esophageal
squamous
cell
carcinoma
with
dural
and
bone
marrow
metastases
.
We
also
discuss
the
pathogenesis
of
unusual
metastatic
diseases
and
differential
diagnosis
of
pachymeningeal
thickening
.
Diseases
Validation
Diseases presenting
"advanced stage at the time of diagnosis"
symptom
esophageal squamous cell carcinoma
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