The Uncharted Territories of Esophageal Cancer with Cardiac and Skeletal Muscle Metastasis: A Case Report and Literature Review

TL;DR

A rare case of esophageal cancer with unusual spread to heart and muscle tissues is reported, highlighting the potential of ctDNA for early detection and the need for better screening.

Contribution

This case report presents a rare instance of esophageal cancer with cardiac and skeletal muscle metastasis and emphasizes the role of ctDNA in monitoring recurrence.

Findings

The patient had P53-positive esophageal cancer with metastasis to cardiac and skeletal muscles.

Multimodal therapy, including immunotherapy, contributed to prolonged survival despite poor prognosis.

ctDNA remained positive even with negative scans, indicating its potential as a recurrence predictor.

Abstract

Background: Esophageal cancer (EC) comprises 1% of all diagnosed cancers in the USA. It is more common in other parts of the world. If there is distant metastasis, the relative survival rate is 6%. There are no standardized screening methods for EC. Case Presentation: We reported a four-year case of esophageal cancer, a P53-positive mutation with atypical distant metastasis to the cardiac and skeletal muscles. The patient was managed with multimodal therapy, including immunotherapy, which could have been a factor in prolonged survival. Conclusions: Distant metastases are typically seen postmortem, and with prolonged survival, we are able to find such unique metastases antemortem. Despite a history of negative scans, the patient’s ctDNA (circulating tumor DNA) remained positive, which was a better predictor of recurrence in this case. Future research is required to establish cost-effective screening methods and standardized treatments.

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