# A rare case report on esophageal squamous cell carcinoma metastatic to the pancreas

## TL;DR

This paper reports a rare case of esophageal cancer spreading to the pancreas and challenges in confirming the diagnosis.

## Contribution

The novelty lies in the detailed clinical and molecular investigation of a rare metastatic case with inconclusive tumor origin testing.

## Key findings

- Pancreatic and lung masses were found during staging of esophageal cancer.
- Histological confirmation of metastasis was difficult, and tumor origin testing was inconclusive.
- Treatment with chemotherapy and immunotherapy was initiated despite diagnostic uncertainty.

## Abstract

Pancreatic metastasis of esophageal squamous cell carcinoma is extremely rare. We describe a case of man aged 66 years who presented with a 3-month history of dysphagia. Esophagogastroduodenoscopy demonstrated an esophageal mass. Additional asymptomatic solitary lung and pancreatic masses were observed in the staging work-up for esophageal cancer, concerning for metastatic versus synchronous primary malignancy. Computed Tomography guided needle biopsy of the lung and pancreatic masses was performed. Given the difficulty to definitively histologically confirm both the lung and the pancreatic masses were metastasis from the primary esophageal cancer, next generation sequencing and tumor origin testing was performed. Tumor origin testing was indeterminate with the molecular profile inconclusive. Treatment was initiated with chemotherapy and immunotherapy.