Esophageal Metastasis of Breast Cancer Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration Cytology—Report of a Case—

Abstract

The case involved a 68-year-old woman who had undergone left mastectomy for left breast cancer 29 years previously. Three years before she became aware of difficulty in swallowing and then she had been treated with repeated balloon dilatation for esophageal stenosis elsewhere. However, symptomatic remission was not achieved, and she became unable to take oral ingestion. Endoscopic biopsy of the esophageal mucosa revealed no malignant findings. A CT scan, however, indicated wall thickening completely encircling the thoracic esophagus and a sclerotic change of the vertebra. Following a bone biopsy, she was diagnosed with bone metastasis of breast cancer. Considering a possibility of esophageal metastasis of breast cancer, we performed endoscopic ultrasound-guided fine-needle aspiration cytology. The histopathological findings were identical with those of the bone biopsy. Consequently, she was diagnosed as suffering esophageal metastasis of breast cancer. Esophageal stenting was performed, and drug therapy for breast cancer was started. In treating esophageal stenosis in patients with a history of breast cancer, we must carry out systemic examination keeping a possibility of esophageal metastasis of breast cancer in mind, where endoscopic ultrasound-guided fine-needle aspiration is useful in making the diagnosis.