Unusual subcutaneous and choroidal metastases from esophageal squamous cell carcinoma denote a poor prognosis: A case report and literature review

Summary Esophageal squamous cell carcinoma (ESCC) is a devastating disease, generally diagnosed at an advanced stage. Skin metastasis is rare, and choroidal metastases are extremely rare. Herein, we report a case of a 47‐year‐old habitual smoker and drinker who presented with progressive dysphagia, weight loss, and multiple enlarged tumors over his trunk and limbs for 3 months. Upper endoscopy revealed an ulcerative esophageal mass, and pathology confirmed moderately differentiated SCC. Fluorodeoxyglucose‐positron emission tomography/computed tomography revealed high uptake in the esophageal mass, bone, and subcutaneous lesions. Incisional biopsy of the right thigh tumor indicated metastatic SCC. Accordingly, the patient received palliative chemotherapy and mediastinal radiotherapy. Two weeks later, he experienced partial right visual field loss. Imaging findings suggested choroidal metastasis. Although the skin lesions shrank after treatment, the patient's health quickly deteriorated and he died of severe pneumonia 3 months later. To our knowledge, this is the first report of ESCC with simultaneous subcutaneous and ocular metastasis. Cutaneous and ocular metastases secondary to ESCC are extremely rare; both suggest cancer dissemination and imply an ominous prognosis. Careful physical examination and high awareness are required during follow‐up. Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.