title: Characteristics of brain metastases from esophageal carcinoma.
abstract: BACKGROUND
  Esophageal carcinoma (EC) is a major malignancy with a poor prognosis. Although esophageal cancers rarely metastasize to the brain, the number of patients diagnosed with brain metastases (BM) from EC is steadily increasing. Therefore, the risk factors for BM from EC should be known. Here we reviewed our experiences and the previous literature regarding BM from EC.
  
  
  METHODS
  Between 2000 and 2013, we retrospectively reviewed the clinical features and neurological findings of 19 patients diagnosed with and treated for BM from EC to determine the clinical risk factors and features.
  
  
  RESULTS
  In all patients, the lesions were partially or completed located in the thoracic esophagus, and the average size of the EC lesion at diagnosis was 5.8 ± 2.9 cm, which was smaller than the previously reported size of EC lesions accompanied by BM. Patients without lung metastases were more common than those with lung metastases. The lesions in the 13 patients included squamous cell carcinoma (SqCC) in 9 (69.2%) and small cell carcinoma (SmCC) in 3 (23.0%). Six patients were not examined. Although there was no trend toward a higher incidence of BM in patients with adenocarcinoma and SqCC, this trend was observed in patients with SmCC. Excluding a single patient with SmCC, all patients had beyond stage III disease at EC diagnosis.
  
  
  CONCLUSIONS
  Our study suggests that BM can occur in patients with EC lesions smaller than those previously reported; moreover, SmCC may be a risk factor for BM from EC.
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan ; Department of Neurosurgery, Saiseikai Kumamoto Hospital, 1-3-5, Chikami, Kumamoto 861- 4193, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Jun-Ichiro
authors.initials: J
authors.lastname: Kuroda
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takezaki
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shinojima
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Takuichiro
authors.initials: T
authors.lastname: Hide
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Makino
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yano
authors.affiliation: Department of Neurosurgery, Saiseikai Kumamoto Hospital, 1-3-5, Chikami, Kumamoto 861- 4193, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Nishi
authors.affiliation: Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860 - 8556, Japan.
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kuratsu
keywords: Adenocarcinoma; brain metastases; esophageal carcinoma; small cell carcinoma; squamous cell carcinoma