Oligometastatic recurrence of an oesophageal adenocarcinoma at a chest drain site following radical treatment: palliative treatment or resection?

Clin J Gastroenterol. 2018 Dec;11(6):470-475. doi: 10.1007/s12328-018-0890-0. Epub 2018 Aug 25.

Abstract

A 62-year-old female patient diagnosed with oesophageal adenocarcinoma underwent radical treatment consisting of neoadjuvant chemotherapy and oesophagectomy with no major complications. Eleven months later, she re-presented with a mass at one of the chest drain sites. A PET-CT scan and biopsy demonstrated this to be a single recurrence of the oesophageal adenocarcinoma. Excision of the metastatic lesion was considered as per metachronous single site metastasis. However, the operation was postponed due to acute kidney injury. Restaging after 6 weeks revealed progressive metastatic disease. The patient underwent palliative therapy and passed away soon after. Oesophageal cancer recurrence has a very poor prognosis, and factors such as the disease-free interval, site of recurrence and tumour pathological factors must be considered when stratifying for suitability for metastasectomy. A period of watchful waiting followed by restaging is essential to rule out patients with indolent metastatic disease.

Keywords: Oesophageal cancer; Oesophagectomy; Oligometastasis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Biopsy
  • Drainage
  • Esophageal Neoplasms / pathology*
  • Esophageal Neoplasms / therapy
  • Esophagectomy
  • Female
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasms, Second Primary / diagnostic imaging
  • Neoplasms, Second Primary / secondary*
  • Neoplasms, Second Primary / therapy
  • Palliative Care
  • Positron Emission Tomography Computed Tomography
  • Thoracic Neoplasms / diagnostic imaging
  • Thoracic Neoplasms / secondary*
  • Thoracic Neoplasms / therapy
  • Thoracic Wall / diagnostic imaging
  • Thoracic Wall / pathology*

Supplementary concepts

  • Adenocarcinoma Of Esophagus