Esophageal cancer is a
rare disease. In Spain, this
tumor is the third most common gastrointestinal
malignancy after colorectal and
gastric cancer. Esophageal
adenocarcinoma metastasizes to the skin with an incidence of 1 %, generally located in the neck, head and abdomen. It usually occurs in the overlying skin of the primary
tumor, but may also appear in a distant site, the scalp being the most common place. Although the pathogenesis of esophageal
adenocarcinoma is not well known, the existence of genetic alterations, such as the suppressor gene, has been proved and the involvement of oncogene c-erbB-2 amplified.
Cytokeratin 20 and 7 are expressed in esophageal
adenocarcinoma. Typically, cutaneous
metastases from internal
malignancy present as firm asymptomatic nodules. These nodules usually occur in multiple arrays on the skin adjacent to the primary
tumor; however, they can occasionally become painful spontaneously. The main diagnostic test of
esophageal cancer is the upper endoscopy, along with histopathology for confirmation of the
tumor. The developments in surgery and the discovery of new
cytotoxic agents have considerably decreased the locoregional recurrence. To date, the combination of these treatment modalities for advanced
adenocarcinoma revealed that the recurrences mainly occur from hematic spread. Excision of the skin lesions produces
pain palliation. In patients diagnosed with
esophageal cancer who have responded satisfactorily to treatment with
chemotherapy, radiation and surgery while having a long history of remission, and dermatology outpatient visits by the appearance of skin lesions, should make us think among the different differential diagnoses, the possibility of cutaneous
metastases.