A 70-year-old woman was admitted for difficulty in swallowing.
Esophageal cancer (MtLt, type 3, T4N3M0, cStage IVa) was diagnosed in May 2010. The
cancer was unresectable, and
chemoradiotherapy (CRT) with
TS-1 was initiated in June 2010, and a partial response (PR) was observed. After CRT,
TS-1 was continued, but a brain
metastasis was detected owing to the development of right
hemiplegia in April 2012.
Craniotomy and tumorectomy were performed, and the right
hemiplegia improved. Pathological examination of the
brain tumor indicated
squamous cell carcinoma. Because of a recurrence of brain
metastasis, a gamma knife procedure was performed in May 2012. Subsequently, several recurrences of
brain metastases were diagnosed, and a total of 7 gamma knife procedures were performed up to January 2014. Although systemic
chemotherapy (
5-fluorouracil and
cisplatin [FP], 5 courses)was administered, the patient showed progressive lung
metastases in February 2013. The
chemotherapy regimen was changed from FP to
docetaxel (TXT), but the lung
metastases continued to progress up to June 2013. The patient died in March 2014. Patients with
esophageal cancer and
metastases to the brain have poor prognosis, but the present patient survived approximately 2 years after first diagnosis of
metastases to the brain after multidisciplinary
therapy.