Abstract
Özefagus kanseri dünya çapında en fazla
bildirilen kanserlerden biridir. En sık uzak metastaz yaptığı organlar
sırasıyla karaciğer, akciğer ve kemiklerdir. Beklenmedik metastazları seri
çalışmaları ile araştırılmıştır. Bu çalışmada skuamöz hücreli
özefagus kanserinin abse şeklinde prezente olan kalvaryal metastazının
radyolojik bulgularını sunmayı amaçladık. 55 yaşında kadın hasta disfaji
şikayeti ile Gastroenteroloji polikliniğine başvurdu. Bilgisayarlı tomografide
(BT) özefagus orta-distal kesiminde
asimetrik duvar kalınlık artışı ve
proksimalinde dilatasyon saptandı.
Yapılan kontrastlı beyin manyetik rezonans görüntüleme (MRG) tetkikinde sağ
paryetal kemikte yoğun içerikli kistik görünüm saptandı. Girişimsel radyoloji
ünitesinde yoğun içerikli kistik görünüm ultrasonografi(US) ile aspire edildi.
Aspire edilen içeriğin pürülan vasıfta olduğu görüldü.Sitopatolojik
değerlendirme ise skuamöz hücreli karsinom metastazı şeklinde raporlandı.
Olgumuzda literatürde bildirildiğinden farklı olarak metastatik kitlenin santrali
MRG ve US incelemede yoğun içerikli koleksiyon şeklinde görüntüleme özellikleri
göstermekteydi. Yaptığımız ultrasonografi eşliğinde aspirasyonda metastatik
kitlenin büyük bölümü pürülan
vasıftaydı. Kalvaryal metastatik lezyonlar genellikle ağrısız lokal
şişliğe neden olurlar. Bu nedenle kalvaryumda kitle ile başvuran hastalarda,
hastanın klinik bulguları ile ilişkili metastatik kitleler ayırıcı tanıda
düşünülmelidir.
References
- 1. Fitzmaurice C, Dicker D, et al. The global burden of cancer 2013. JAMA Oncol 2015;1: 505–527.
- 2. Lepage C, Rachet B, Jooste V, Faivre J, Coleman MP. Continuing rapid increase in esophageal adenocarcinoma in England and Wales. Am J Gastroenterol 2008;103:2694–2699.
- 3. Quint LE, Hepburn LM, Francis IR, Whyte RI, Orringer MB. Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma. Cancer 1995;76:1120–1125.
- 4. Kim TJ., Kim HY., Lee KW., Kim MS., MD Multimodality assessment of esophageal cancer: preoperative staging and monitoring of response to therapy RadioGraphics 2009;29:403–421.
- 5. Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 2003;349(23):2241–2252.
- 6. Chen YH, Huang CH. Esophageal squamous cell carcinoma with dural and bone marrow metastases. World J Gastroenterol 2014;20:12691-5.
- 7. Laigle-Donadey F, Taillibert S, Martin Duverneuil N, Hildebrand J, Delattre JY. Skull-base metastases. J Neurooncol 2005;75:63–69.
- 8. Mitsuya K, Nakasu Y, Horiguchi S, Harada H, Nishimura HT, Yuen S, Asakura K, Endo M. Metastatic skull tumors: MRI features and a new conventional classification J Neurooncol 2011;104:239–245
- 9. Shaheen O,Ghibour A,Alsaid B. Esophageal cancer metastases to unexpected sites: a systematic review Gastroenterol Res Pract. 2017;2017:1657310.
- 10. Stark AM, Eichmann T, Mehdorn HM. Skull metastases: clinical features,differential diagnosis, and review of the literature. Surg Neurol 2003; 60:219-225.
- 11. Ellis MJ, McDonald PJ. Acute epidural hematoma secondary to skullmetastasis from esophageal carcinoma. Can J Neurol Sci 2007;34:491-493.
Abstract
Esophageal cancer is one of
the most reported cancers worldwide. The most common organs of distant
metastasis are the liver, lungs and bones, respectively. Unexpected metastases
were only investigated in case series. In this study, we aimed to present
radiological findings of calvaryal metastasis of squamous cell esophageal
cancer with abscess formation. A 55-year-old woman was admitted to Gastroenterology
outpatient clinic with the complaint of dysphagia. In the computed tomography
(CT), increased asymmetric wall thickness and proximal dilatation were detected
in the mid-distal section of the esophagus. Contrast-enhanced cerebral magnetic
resonans imaging (MRI) showed a cystic appearance in the right parietal
bone.Cystic appearance was aspirated by ultrasonography (US) in the interventional radiology unit. Aspirated material was purulent.
Cytopathological evaluation was reported as squamous cell carcinoma metastasis.
In our case, unlike reported in the literature, the metastatic mass showed
collection with dense content at the center on MRI and US examination. We
observed that most of the metastatic mass was purulent in
ultrasonography-guided aspiration. Calvarial metastatic lesions usually cause
painless local swelling. Therefore,
patients admitted with a calvarial mass, metastatic masses associated
with the patient's clinical findings should be considered in the differential
diagnosis.
References
- 1. Fitzmaurice C, Dicker D, et al. The global burden of cancer 2013. JAMA Oncol 2015;1: 505–527.
- 2. Lepage C, Rachet B, Jooste V, Faivre J, Coleman MP. Continuing rapid increase in esophageal adenocarcinoma in England and Wales. Am J Gastroenterol 2008;103:2694–2699.
- 3. Quint LE, Hepburn LM, Francis IR, Whyte RI, Orringer MB. Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma. Cancer 1995;76:1120–1125.
- 4. Kim TJ., Kim HY., Lee KW., Kim MS., MD Multimodality assessment of esophageal cancer: preoperative staging and monitoring of response to therapy RadioGraphics 2009;29:403–421.
- 5. Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 2003;349(23):2241–2252.
- 6. Chen YH, Huang CH. Esophageal squamous cell carcinoma with dural and bone marrow metastases. World J Gastroenterol 2014;20:12691-5.
- 7. Laigle-Donadey F, Taillibert S, Martin Duverneuil N, Hildebrand J, Delattre JY. Skull-base metastases. J Neurooncol 2005;75:63–69.
- 8. Mitsuya K, Nakasu Y, Horiguchi S, Harada H, Nishimura HT, Yuen S, Asakura K, Endo M. Metastatic skull tumors: MRI features and a new conventional classification J Neurooncol 2011;104:239–245
- 9. Shaheen O,Ghibour A,Alsaid B. Esophageal cancer metastases to unexpected sites: a systematic review Gastroenterol Res Pract. 2017;2017:1657310.
- 10. Stark AM, Eichmann T, Mehdorn HM. Skull metastases: clinical features,differential diagnosis, and review of the literature. Surg Neurol 2003; 60:219-225.
- 11. Ellis MJ, McDonald PJ. Acute epidural hematoma secondary to skullmetastasis from esophageal carcinoma. Can J Neurol Sci 2007;34:491-493.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Radiology and Organ Imaging |
| Journal Section | Case Report |
| Authors | |
| Publication Date | January 21, 2020 |
| Submission Date | July 6, 2019 |
| Acceptance Date | November 29, 2019 |
| Published in Issue | Year 2020 Volume: 13 Issue: 1 |
