Occult esophageal squamous cell carcinoma with metastases to the spine and central nervous system.
Esophageal malignancy encompasses a group of diseases that are mostly represented by the squamous cell carcinoma and the adenocarcinoma. Quite frequently, these neoplasms present aggressive behavior; therefore, the diagnosis is often made when the condition is in advanced stages. Dysphagia is the typical clinical complaint, although it is present only when most of the lumen is obstructed. Therefore, quite often, the metastatic disease is first diagnosed, which contributes to the patient's poor survival expectancy. The authors report the case of a 58-year-old man who looked for medical care complaining of a long-term history of scapular pain. The diagnostic work-up disclosed a cervical spine lytic lesion surrounded by a tumoral mass shown by computed tomography. The cervical tumor was sampled by fine needle aspiration, revealing an undifferentiated carcinoma. The outcome was unfavorable and the patient died. The autopsy findings revealed metastatic disease to the spine and central nervous system, and the primary tumor was found to be an esophageal squamous cell carcinoma, which had progressed without typical dysphagia.
Faculty of Medicine - Pontifícia Universidade Católica de Campinas, São Paulo/SP, Brazil .
Ana Lídia
AL
Viaro
Internal Medicine Department - Pontifícia Universidade Católica de Campinas, São Paulo/SP, Brazil .
Carla Adriane
CA
Roballo
Internal Medicine Department - Pontifícia Universidade Católica de Campinas, São Paulo/SP, Brazil .
Pompeu Tomé Ribeiro
PT
de Campos
Internal Medicine Department - Pontifícia Universidade Católica de Campinas, São Paulo/SP, Brazil .
Carlos Osvaldo
CO
Teixeira
Internal Medicine Department - Pontifícia Universidade Católica de Campinas, São Paulo/SP, Brazil .
Maria Aparecida Barone
MA
Teixeira
Brain; Carcinoma, Squamous Cells; Esophageal Neoplasm; Neoplasm Metastasis; Spine