title: Esophageal squamous cell carcinoma presenting with extensive skin lesions: a case report.
abstract: BACKGROUND
  Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of cancer in the upper and middle esophagus and is characterized by a high rate of mortality. The incidence of esophageal cancer varies greatly among regions of the world and occurs at a high frequency in Asia and South America.
  
  
  METHODS
  In our department, a 51-year-old man was diagnosed with ESCC after presenting with extensive disseminated skin nodules. Biopsy of the nodules showed metastatic ESCC. Cutaneous manifestations of esophageal neoplasia are very rare and are mainly described for esophageal adenocarcinoma (EADC). Here we report a very uncommon case of extensive skin metastases of ESCC.
  
  
  CONCLUSIONS
  Early biopsies of suspicious skin lesions are important and should be performed in patients with unclear symptoms such as weight loss or dysphagia and especially in patients with a history of cancer, since they can reveal the existence of a distant malignant disease leading to diagnosis and prompt therapy.
authors.affiliation: Department of Internal Medicine, Oncology and Hematology, University Hospital Hamburg, Eppendorf, Martinistrasse, Hamburg, Germany. g.iwanski@uke.uni-hamburg.de
authors.forename: G B
authors.initials: GB
authors.lastname: Iwanski
authors.forename: A
authors.initials: A
authors.lastname: Block
authors.forename: G
authors.initials: G
authors.lastname: Keller
authors.forename: J
authors.initials: J
authors.lastname: Muench
authors.forename: S
authors.initials: S
authors.lastname: Claus
authors.forename: W
authors.initials: W
authors.lastname: Fiedler
authors.forename: C
authors.initials: C
authors.lastname: Bokemeyer