Isolated Pancreatic Metastasis from Esophageal Squamous Cell Carcinoma: A Rare Case Report with Review of Literature

Esophageal squamous cell carcinoma (ESCC) is an aggressive malignancy with a propensity for distant metastasis, though isolated pancreatic involvement is exceedingly rare (1% of cases). Due to its rarity, pancreatic metastasis from ESCC presents significant diagnostic and therapeutic challenges, often mimicking primary pancreatic tumors. We report a case of a 59-year-old male with a history of ESCC (pT3N2M0) who developed an isolated pancreatic metastasis detected on surveillance PET-CT. The patient underwent successful distal pancreatectomy, with histopathology confirming metastatic squamous cell carcinoma. At three-month follow-up, he remained disease-free. Pancreatic metastasis from ESCC is a rare phenomenon, with only a few documented cases in the literature. This case highlights the role of PET-CT in detecting occult metastases and supports surgical resection (distal pancreatectomy) as a viable treatment option for solitary lesions, even in the setting of prior nodal involvement. The absence of recurrence in our patient suggests that aggressive local therapy may improve outcomes in selected cases. Isolated pancreatic metastasis from ESCC, though uncommon, should be considered in patients with a history of esophageal cancer presenting with a pancreatic mass. This case report underscores the importance of multidisciplinary management, including surgical resection when feasible, to achieve favorable oncologic outcomes. Further studies are needed to establish optimal surveillance and treatment strategies.