1 Mar 2013Case Report
A case of oesophageal cancer with low back pain: the accidental finding of skeletal muscle metastasis
Giovanni Leuzzi 1Alfredo Cesario 2Stefano Margaritora 3Anna Parisi 1Venanzio Porziella 1Elisa Meacci 1Maria Vita 1Maria Congedo 1Marco Chiappetta 1Pierluigi Granone 1
Affiliations
Article Info
1 Department of General Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy
2 Department of General Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy; Deputy Scientific Director, IRCCS San Raffaele Pisana, Rome, Italy
3 Department of General Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy; Department of Thoracic Surgery, Centro Oncologico Fiorentino, Florence, Italy
Ann. Ital. Chir., 2013, 84(2), 193-195;
Published: 1 Mar 2013
Copyright © 2013 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Skeletal muscle metastasis is a very rare event in patients with oesophageal cancer. We herein report and discuss a case of a 65 years old man with history of gastro-esophageal reflux disease referred to our department for pyrosis associated to persistent low back pain. Oesophageal endoscopy and transesophageal endo-sonography showed a tumour localized in the lower third of the esophagus, histologically proved to be adenocarcinoma. Clinical staging procedures detected a two centimetres vascularized nodular lesion placed into right para-vertebral muscles at the level of L4 as the only sign of potential distant disease (versus a differential diagnosis of primitive sarcoma). The muscle lesion was completely removed and confirmed as secondary adenocarcinoma. Due to this evidence a chemotherapy protocol was initiated. After nine months the patient underwent transhiatal oesophagectomy. To the best of our knowledge this is the first reported case of a soft tissue metastasis from oesophageal cancer resected with radical intent
Keywords
- Low back pain
- Oesophageal adenocarcinoma
- Skeletal muscle metastasis