Esophageal squamous cell carcinoma with pulmonary and hepatic metastasis
Presentation
Chronic dysphagia.
Patient Data
There is a circumferential, irregular, and asymmetric increase in mural thickness (up to 18.0 mm in the maximum thickness at the gastric cardia) of the esophagus from the D9 level and extending into the esophagogastric junction and cardia of the stomach with significant surrounding fat stranding.
Luminal narrowing of the involved part with retro-grade dilatation and air-fluid level is also appreciated.
No CT-detectable criteria for invasion of the surrounding organs are noted.
An enlarged lymph is also noted in the left retrocrural region.
Multiple, variable in size and shape, subpleural and intra-parenchymal, cavitating and non-cavitating, soft tissue density lesions are noted in both lungs with differential secondary deposits.
Multiple, enlarged and matted lymph nodes are noted in the vicinity of the lesser curvature.
The liver is mildly enlarged in size with a normal position and has smooth borders. Multiple, variable in size and shape (predominantly hypodense lesions, which are showing no definite density changes on provided phases). The internal structure and attenuation values are normal. The hepatic and portal veins are patent. The intrahepatic and extra-hepatic bile ducts are unremarkable.
Slices through the kidneys show a few simple cysts as well.
Case Discussion
Biopsy-proven esophageal squamous cell carcinoma with extension into the stomach, regional lymphadenopathy, hepatic and pulmonary metastasis (cT3N3M1).
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