Esophageal Squamous Cell Carcinoma with Skin Metastasis-A Case Report and Review of Literature

食道鱗狀細胞癌以皮膚病灶為初始表徵－一個病例報告

陳信翰(Hsin-Han Chen) ； 吳肇毅(Chao-I Wu) ； 周爾康(Erh-Kang Chou) ； 林孟羲(Meng-Shi Lin) ； 江宜平(I-Ping Chiang) ； 張家寧(Sophia Chia-Ning Chang)

《中華民國整形外科醫學會雜誌》 16卷3期 (2007/09) Pp. 241-245

https://doi.org/10.7096/JPSA.200709.0241

摘要

皮膚的轉移性腫瘤並不少見，最常見是從肺癌或乳房癌移轉而來，從食道癌轉移到皮膚的病例非常少。當轉移性腫瘤發生在臉上時，因為其型態的多變性，要和皮膚原發性癌症區別而做正確診斷常常是一種挑戰。我們要報告一個食道癌的病例，其最初的癌症表現是在左臉頰的皮膚，當時由於很小也沒有症狀，病人以為是青春痘並沒有求助醫療診所。三個月後病人因為發燒及胸痛經胸部X光檢查為膿胸而轉診到我們醫院而意外發現食道癌。當時左臉頰的病灶只有0.1x0.1平方公分。在經過開刀及放射線治療後五個月，腫塊變成3x2x0.5立方公分。經過切片檢查證實為食道癌轉移，我們為其做切除及補皮，這是文獻上第一個食道鱗狀上皮細胞癌轉移到皮膚的案例，根據文獻，確實是有些線索可以做為早期診斷的依據，但畢竟還是不太容易區分，尤其在早期，詳細的問診及理學檢查加上隨時警覺的心，另外有懷疑時要做切片檢查還是最好的方法。

並列摘要

The skin metastasis from carcinoma arising in other organ is not uncommon, yet it may be the first presentation of neoplastic diseases. When they occur on the face, their pleomorphic presentation may lead to misdiagnosis. However, esophageal cancer metastasis to skin is rather rare. We report a case of esophageal squamous cell carcinoma with metastasis to the skin as its first clinical manifestation. To our acknowledgement from the literature, this is the first report of esophageal squamous cell carcinoma with cheek skin metastasis. Although there are some clues of the cutaneous lesions to help us in differential diagnosis, the detailed history and physical examination with a highly alert attitude are still the best way for early cancer detection. The skin biopsies from suspicious lesions should be performed without exception.

並列關鍵字

esophageal cancer ； skin metastasis