Atypical presentation of an oesophageal carcinoma with metastases to the left buttock: a case report
1 Department of General Surgery, Daisy Hill Hospital, Newry BT35 8DR, Northern Ireland
2 Faculty of Life and Health Sciences, University of Ulster, Jordanstown Campus, Shore Rd, Newtownabbey BT37 0QB, Northern Ireland
Cases Journal 2009, 2:6691 doi:10.1186/1757-1626-2-6691Published: 18 May 2009
Oesophageal carcinomas represent 3% of all cancers in the UK accounting for 7650 new cases per annum. Oesophageal cancer may be associated with swallowing abnormalities, localised mass pressure effects, lymphatic or distant metastatic spread.
We report a 50-year-old man who presented with a painful, enlarging, solid, fixed lesion adjacent to the left buttock with associated dysphagia. Initial endoscopic assessment suggested severe oesophageal inflammation while the lesion in the buttock area was presumed to be a primary soft-tissue neoplasm. However, subsequent histological assessment confirmed a primary oesophageal squamous carcinoma with metastatic spread to the buttock.
We discuss the clinical presentation, investigative modalities, and current therapeutic guidelines associated with this rare metastasis and present other atypical oesophageal musculoskeletal metastases. We emphasise the need to consider all aspects of patient symptomatology during the investigation of any atypical lesion.