Management of Metachronous Dual Primary Esophageal Carcinomas: A Case Study

Overview

This report details a rare case of metachronous esophageal squamous cell carcinoma (SCC) following treatment for adenoid cystic carcinoma (ACC). The patient achieved complete remission after definitive chemoradiotherapy, highlighting the importance of surveillance for secondary malignancies.

Background

Esophageal adenoid cystic carcinoma (ACC) is an extremely rare malignancy, comprising only 0.04%–0.16% of esophageal cancers. The occurrence of second primary malignancies (SPMs) in esophageal cancer patients is significant, with metachronous tumors presenting unique challenges in management. Understanding the relationship between ACC and subsequent malignancies is crucial for improving patient outcomes.

Data Highlights

No numerical data or trial data was presented in the article.

Key Findings

• First documented case of metachronous SCC developing outside the radiation field after ACC treatment.
• The patient had a significant smoking history and presented with dysphagia.
• Initial diagnosis of ACC was confirmed with a high Ki-67 proliferative index (80%).
• Postoperative radiotherapy was well tolerated, with minimal side effects.
• Complete remission of SCC was achieved following definitive chemoradiotherapy.
• The patient remained disease-free at the most recent follow-up in March 2026.

Clinical Implications

This case underscores the necessity for comprehensive endoscopic surveillance in patients treated for esophageal ACC to detect secondary malignancies early. The successful management of metachronous malignancies with curative intent is feasible when identified promptly.

Conclusion

The findings from this case highlight the potential for secondary malignancies to arise after treatment for esophageal ACC, necessitating vigilant monitoring. Effective treatment strategies can lead to favorable outcomes in such complex cases.

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