Synchronous solitary small intestinal metastasis from esophageal squamous cell carcinoma: report of a case

A 69-year-old male was referred to our hospital with squamous cell carcinoma of the lower thoracic esophagus and a chief complaint of vomiting. On positron emission tomography, fluorodeoxyglucose accumulation was detected in the primary tumor and paraesophageal lymph node. Thoracic esophagectomy and 3-field lymphadenectomy were performed following the administration of neoadjuvant chemotherapy composed of fluorouracil plus cisplatin. Intraoperatively, during the catheter jejunostomy procedure for enteral nutrition, a jejunal nodule measuring 1.5 cm in size at 35 cm distal from the Treitz ligament was detected. The nodule was completely resected using partial jejunotomy. A submucosal tumor-like elevated lesion was seen in the resected specimen. Histologically, squamous cell carcinoma invaded the muscularis propria. Lymphovascular permeation was observed. The patient's postoperative course was uneventful, and he was discharged on postoperative day 25. After 4 months, CT showed recurrence of multiple liver metastases. Unfortunately, the patient died 6 months after the operation.