Esophagus
Carcinoma
Metastases

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 23 January 2018, last major update November 2013

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Esophagus[TI] metastases[TI]

Cite this page: Weisenberg, E. Metastases. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagusmetastases.html. Accessed May 24th, 2018.
Definition / general
  • WHO definition: tumors of esophagus that originate from an extra-esophageal neoplasm or that are discontinuous with a primary tumor elsewhere in the esophagus
  • Direct spread from lung, stomach, pharynx, larynx, thyroid or mediastinal lymph nodes containing tumor is more common
Epidemiology
  • Most common are breast and lung
  • Melanoma is the next most common affecting 4% of patients, although primary esophageal melanoma must be excluded
  • Thyroid, cervix, ovary, prostate, kidney and endometrium have also been reported
  • Esophagus is most common GI site of lung metastasis
Sites
  • Most common site is middle third of esophagus
Pathophysiology
  • May spread via lymphatics or hematogenously
  • Lymphatic spread is most commonly associated with breast and lung tumors
Clinical features
Diagnosis
  • Endoscopic biopsy often performed
Radiology images

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Perforation at gastroesophageal junction

Thickening of esophageal wall

Thickening of fourth layer around esophagus

Prognostic factors
  • Most patients have a poor prognosis but tumors that are amenable to systemic or radiation therapy may have better outcomes
Case reports
Clinical images

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Mucosa appears normal at stricture

Gross description
  • Typically form submucosal nodules
  • Less commonly large, obstructive lesions
Gross images

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Resected specimen

Microscopic (histologic) images

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Breast metastasis



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Breast: adenocarcinoma beneath the mucosa

Breast: lobular carcinoma (ER+)

Differential diagnosis
  • Direct spread of adjacent malignancy
  • Primary esophageal malignancy
Additional references