2019 Volume 39 Issue 4 Pages 733-737
A 54-year-old man diagnosed with esophageal cancer with multiple metastasis was referred to our hospital. While receiving chemoradiotherapy, severe hematochezia and anemia were detected. Computed tomography revealed intestinal hemorrhage, and emergency surgery was performed. Nodules were detected in the small intestinal wall, which were the source of the hemorrhage. Partial resection of the small intestine was subsequently performed. Pathological examination of the resected intestinal wall showed lesions with vascular invasion present across the mucosal to subserosal layers. They were diagnosed as metastases from the esophageal cancer. The patient recovered uneventfully but he died on postoperative day 56 due to disease progression. Metastasis of esophageal cancer to small intestine is rare, mostly occurring as part of systemic multiple metastases. Such metastases can cause intestinal obstruction or perforation, however the necessity of surgical intervention as an oncological emergency due to persistent hemorrhage has been rarely reported. Careful clinical evaluation is essential for surgery, considering the extremely short survival rate.
