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Clinical Journal of Gastroenterology

, Volume 11, Issue 2, pp 113–117 | Cite as

Long-term survival after multidisciplinary therapy for brain metastases from asymptomatic esophageal adenocarcinoma

  • Takeshi Matsutani
  • Nobutoshi Hagiwara
  • Tsutomu Nomura
  • Itsuo Fujita
  • Yoshikazu Kanazawa
  • Daisuke Kakinuma
  • Akihisa Matsuda
  • Eiji Uchida
Case Report

Abstract

Asymptomatic T1 (invaded submucosa) esophageal carcinoma rarely metastasizes to the brain. A 53-year-old Japanese man complaining of right hemiparesis and convulsion was admitted to our hospital. Brain imaging demonstrated a ring-like, enhanced brain tumor in the left parietal lobe. The pathological findings of the resected tumor were consistent with a metastatic adenocarcinoma from the gastrointestinal tract. Additional examinations revealed an elevated-type tumor in the lower third of the thoracic esophagus. The patient underwent thoracoscopic esophagectomy with lymph node dissection followed by reconstruction with gastric tube substitution. The immunohistochemical findings of the resected specimen were similar to those of the metastatic brain tumor. Although the patient received adjuvant chemotherapy (5-fluorouracil, docetaxel plus cisplatin), a solitary small brain metastasis was detected 4 months after esophagectomy. Excision of the sequential metastases with whole-brain radiation therapy and gamma-knife therapy were performed. The patient survived for 50 months after beginning the initial treatment. This report describes a rare case of brain metastases from T1 esophageal adenocarcinoma in a patient without gastrointestinal symptoms.

Keywords

Esophageal cancer Adenocarcinoma Brain metastasis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from the patient and patient’s family to be included in the study.

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Copyright information

© Japanese Society of Gastroenterology 2017

Authors and Affiliations

  • Takeshi Matsutani
    • 1
  • Nobutoshi Hagiwara
    • 1
  • Tsutomu Nomura
    • 1
  • Itsuo Fujita
    • 1
  • Yoshikazu Kanazawa
    • 1
  • Daisuke Kakinuma
    • 1
  • Akihisa Matsuda
    • 1
  • Eiji Uchida
    • 1
  1. 1.Department of Gastrointestinal Hepato-Biliary-Pancreatic SurgeryNippon Medical SchoolTokyoJapan

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