A rare case of esophageal metastasis from pancreatic ductal adenocarcinoma: A case report and literature review

Lauren M. Rosati, Megan N. Kummerlowe, Justin Poling, Amy Hacker-Prietz, Amol Narang, Eun Shin, Dung Le, Elliot K Fishman, Ralph H Hruban, Stephen C Yang, Matthew J Weiss, Joseph M. Herman

Research output: Contribution to journalArticle

Abstract

Purpose: We report a very unique case of an esophageal metastasis from a pancreatic ductal adenocarcinoma (PDAC) primary. Methods: After obtaining consent from the patient, all relevant records of the case were obtained and retrospectively reviewed. Results: At presentation, the patient was diagnosed with synchronous pancreatic and esophageal cancer. He received six months of neoadjuvant therapy including FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and stereotactic body radiation therapy (SBRT) to the pancreatic tumor followed by a combined pancreaticoduodenectomy and Ivor Lewis esophagectomy. Review of the final esophageal specimen revealed normal overlying squamous mucosa with an underlying focus of metastatic PDAC. The patient remains alive with no evidence of disease 17 months from surgery and 25 months from diagnosis. Conclusions: Differentiating an esophageal metastasis from a PDAC primary versus a synchronous esophageal carcinoma is very difficult despite state-of-the-art diagnostic techniques performed at a high-volume tertiary cancer center. Extensive evaluation and continued follow-up of PDAC patients presenting with a synchronous esophageal lesion in a multidisciplinary setting may help ensure efficient and accurate management. In our case, neoadjuvant FOLFIRINOX and SBRT to the primary PDAC tumor followed by surgery has been an effective approach for this patient.

Original languageEnglish (US)
Pages (from-to)100942-100950
Number of pages9
JournalOncotarget
Volume8
Issue number59
DOIs
StatePublished - Jan 1 2017

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Keywords

  • Esophageal metastasis
  • Esophagus
  • Metastatic
  • Pancreatic cancer
  • Pancreatic ductal adenocarcinoma

ASJC Scopus subject areas

  • Oncology

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