Zhang Y, Li ZX, Ma DY, Liu F. Solitary esophageal metastasis ten years after curative resection of stage I rectal adenocarcinoma: A case report. World J Gastrointest Oncol 2026; 18(2): 113494 [PMID: 41695926 DOI: 10.4251/wjgo.v18.i2.113494]
Corresponding Author of This Article
Fang Liu, Department of Oncology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong 637000, Sichuan Province, China. fang1986121@126.com
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Oncology
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Case Report
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Feb 15, 2026 (publication date) through May 1, 2026
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World Journal of Gastrointestinal Oncology
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1948-5204
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Zhang Y, Li ZX, Ma DY, Liu F. Solitary esophageal metastasis ten years after curative resection of stage I rectal adenocarcinoma: A case report. World J Gastrointest Oncol 2026; 18(2): 113494 [PMID: 41695926 DOI: 10.4251/wjgo.v18.i2.113494]
World J Gastrointest Oncol. Feb 15, 2026; 18(2): 113494 Published online Feb 15, 2026. doi: 10.4251/wjgo.v18.i2.113494
Solitary esophageal metastasis ten years after curative resection of stage I rectal adenocarcinoma: A case report
Yu Zhang, Zi-Xin Li, Dai-Yuan Ma, Fang Liu
Yu Zhang, Zi-Xin Li, Dai-Yuan Ma, Fang Liu, Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Zhang Y and Ma DY designed the research study; Zhang Y and Liu F performed the research; Zhang Y and Li ZX wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Fang Liu, Department of Oncology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Nanchong 637000, Sichuan Province, China. fang1986121@126.com
Received: August 27, 2025 Revised: November 16, 2025 Accepted: December 25, 2025 Published online: February 15, 2026 Processing time: 160 Days and 16.8 Hours
Abstract
BACKGROUND
We report an exceptionally rare case of a solitary esophageal metastasis occurring in the tenth year after curative resection of stage I (pT2N0M0) rectal adenocarcinoma. This represents one of the longest reported intervals to esophageal metastasis from colorectal cancer, challenging the conventional understanding of metastatic potential of early-stage tumors.
CASE SUMMARY
A 42-year-old male underwent curative resection for rectal adenocarcinoma (pT2N0M0, stage I) in 2015. Ten years later (2025), he presented with progressive dysphagia. Imaging and endoscopy revealed a mid-esophageal tumor with mediastinal lymphadenopathy. Initial biopsy suggested primary esophageal adenocarcinoma. After two cycles of neoadjuvant immunochemotherapy, dysphagia worsened. However, a multidisciplinary team re-evaluation, utilizing comparative immunohistochemistry for the esophageal lesions and rectal specimens, confirmed the diagnosis as a solitary esophageal metastasis from rectal adenocarcinoma (RAS wild-type). The patient received involved-field radiotherapy with concurrent systemic therapy (capecitabine, oxaliplatin and cetuximab). Dysphagia significantly improved one week after radiotherapy initiation. Three-month follow-up imaging after radiotherapy demonstrated a partial response. The patient was on cetuximab maintenance.
CONCLUSION
This case underscores the risk of early tumor recurrence or metastasis beyond standard follow-up windows thus long-term follow-up is necessary.
Core Tip: We report a case of a solitary esophageal metastasis occurring in the tenth year after curative resection of stage I rectal adenocarcinoma, representing one of the longest intervals for rectal metastasis to the esophagus. It emphasizes that even early-stage tumors can metastasize to atypical sites after years. Furthermore, we discuss the role of immunohistochemistry in diagnosis and the potential value of radiotherapy combined with systemic treatment.
