title: Tumor-to-tumor metastasis: esophageal carcinoma metastatic to an intracranial paraganglioma.
abstract: Tumor-to-tumor metastasis (TTM) is a relatively rare but well-documented phenomenon. The authors report a unique case of esophageal carcinoma metastatic to an intracranial paraganglioma. A sellar and suprasellar tumor was found using MR imaging in an 81-year-old man who presented with a 3-week history of progressive headache and blurred vision. A subtotal excision of the tumor was achieved. Histopathological examination of the tumor disclosed a neoplasm with two distinct components: one showing the classic Zellballen pattern of a paraganglioma, the other exhibiting malignant features leading to the diagnosis of a poorly differentiated carcinoma metastatic to a sellar/suprasellar paraganglioma. The primary esophageal carcinoma was not uncovered until 2 months later, after the patient presented with upper gastrointestinal bleeding. The patient died 4 months after initial presentation. This case expands the spectrum of TTM, and emphasizes the importance of TTM in the practice of pathology.
authors.affiliation: Department of Pathology, University of Calgary, Alberta, Canada.
authors.forename: Jian-Qiang
authors.initials: JQ
authors.lastname: Lu
authors.forename: Moosa
authors.initials: M
authors.lastname: Khalil
authors.forename: William
authors.initials: W
authors.lastname: Hu
authors.forename: Garnette R
authors.initials: GR
authors.lastname: Sutherland
authors.forename: Arthur W
authors.initials: AW
authors.lastname: Clark
mesh_terms: D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary*; D002277:Carcinoma / Q000473:pathology* / Q000556:secondary*; D004938:Esophageal Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009378:Neoplasms, Multiple Primary; D010235:Paraganglioma / Q000473:pathology*