Oligometastatic recurrence in radically treated stage II lower thoracic ca oesophagus at two drain sites: a treatment challenge?


  • Jyoti Sharma Department Radiation Therapy and Oncology IGMC Shimla. Himachal Pradesh, India http://orcid.org/0000-0003-1517-3214
  • Lalit Chandrakant Department Radiation Therapy and Oncology IGMC Shimla. Himachal Pradesh, India




Oligometastatic ca oesophagus, Drain site recurrence, Trans hiatal esophagectomy


Ca oesophagus is a dreaded malignancy with less than 15 % cure rate and majority of the patients presenting with advanced unresectable disease. Prognosis remains poor despite advances in combined modality treatments. Most common sites of loco-regional recurrence after surgery remains the mediastinal lymph node clearance area while other common sites are lung liver and bone. Unexpected sites of metastasis have been reported like skin, muscle, eyes etc. We report a case of 66-year-old male patient diagnosed with stage II poorly differentiated squamous cell carcinoma lower oesophagus radically treated with neoadjuvant chemotherapy, trans hiatal esophagectomy followed by adjuvant chemotherapy, who subsequently developed oligometastatic recurrences at two drain sites. Patient was treated with surgical excision followed by radiotherapy and chemotherapy.



Weichselbaum R, Hellman S. Oligometastases revisited. Nat Rev Clin Oncol. 2011;8:378-82.

Shaheen O, Ghibour A, Alsaid B. Esophageal Cancer Metastases to Unexpected Sites: A Systematic Review. Gastroenterol Res Pract. 2017;2017:1657310.

Wen D, Collantes E, Sgromo B. Oligometastatic recurrence of an oesophageal adenocarcinoma at a chest drain site following radical treatment: palliative treatment or resection?. Clin J Gastroenterol. 2018;11:470-75.

Huang AT, Georgolios A, Espino S. Percutaneous endoscopic gastrostomy site metastasis from head and neck squamous cell carcinoma: case series and literature review. J of Otolaryngol - Head & Neck Surg. 2013;42:20.

Ananth S, Amin M. Implantation of oral squamous cell carcinoma at the site of a percutaneous endoscopic gastrostomy: a case report. Br J Oral Maxillofac Surg. 2002;40(2):125-30.

Then EO, Lopez M, Saleem S, Gayam V, Sunkara T, Culliford A et al. Esophageal Cancer: An Updated Surveillance Epidemiology and End Results Database Analysis. World J Oncol. 2020;11(2):55-64.

Khurana R, Mishra H, Malhotra KP, Shukla S. Carcinoma of the oesophagus, with multiple cutaneous metastases. BMJ Case Rep. 2015;2015:bcr2015211653.

Kobayashi N, Kohno T, Haruta S, Fujimori S, Shinohara H, Ueno M et al. Pulmonary metastasectomy secondary to esophageal carcinoma: long-term survival and prognostic factors. Ann Surg Oncol. 2014;21(3):S365-9.






Case Reports