A Case of Dysphagia During the Course of Lung Cancer and Strong Suspicion of Esophageal Metastasis

Background. Esophageal metastasis from lung cancer is a rare clinical status. Case. A 60-year-old man had received chemotherapy since February X for lung adenocarcinoma cT1bN3M1a, stage IVA. During chemotherapy, he complained dysphagia but did not show any abnormal findings on eating and swallowing screening tests. Computed tomography (CT) revealed no compressive extrinsic tumors outside the esophageal wall. The symptoms subsequently progressed, so esophagography was performed. Findings showed stenosis at the mid-esophagus. CT was reinvestigated, indicating a thickened esophageal wall along with worsening lung cancer. Upper gastrointestinal endoscopy showed all-around narrowing with normal mucosa. We diagnosed the dysphagia as being due to esophageal metastasis of lung cancer based on the clinical course and these findings. At the time of the diagnosis of esophageal metastasis, the patient was already in a poor general condition, and it was difficult to change the anticancer drug treatment or local therapy, so a policy of palliative treatment was adopted. Conclusion. When dysphagia occurs during the course of lung cancer, even if no compressive extrinsic tumor or abnormalities on a swallowing screening test are noted, the possibility of lung cancer esophageal metastasis should be considered, and further investigation should be performed in cooperation with other medical professions.