case_images: PMC9912359_01
case_images: Chest and abdomen tomography.. A) Mediastinal subcarinal mass involving the thoracic esophagus from the carina to the gastroesophageal junction with stenosis of the latter under stent management. B) In the lung parenchyma, solid nodular lesions are observed, some with mass criteria, especially in the upper segment of the right lower lobe related to metastatic involvement. C) In the liver, an indeterminate hypodense lesion is observed at the limit between hepatic segments V and VI of approximately 6.5 mm. Adenomegaly in the gastro-hepatic space of 45 x 37 mm. D) Mass behind the tail of the pancreas of the heterogeneous density of approximately 60 mm that seems to correspond to secondary involvement of the left adrenal gland and overdistension of the gallbladder.
case_images: cureus-0015-00000033635-i01.jpg
case_images: PMC9912359_01_cureus-0015-00000033635-i01.jpg
case_images: FIG1
case_images: Bone scan with 99mTc-MDP.. A) Whole body scan in anterior and posterior projection and SPECT/CT. High-uptake bone lesions are observed in the scapulae, proximal third of the left humerus, B) vertebral body of T5, eleventh posterior left costal arch, right ischium, and greater trochanter of the right femur secondary to metastatic involvement.. MDP: methylene diphosphonate
case_images: cureus-0015-00000033635-i02.jpg
case_images: PMC9912359_01_cureus-0015-00000033635-i02.jpg
case_images: FIG2
case_images: Histopathological study of the esophageal tumor.. A) H&E 4x submucosa of the esophagus infiltrated by tumor cells, cells with clear cytoplasm, atypical nuclei, some with prominent nucleoli, B) mitotic figures are also observed. positive immunohistochemical studies: C) AE1/AE3 10X 3, D. PAX8 10X, E) CAIX 10X.
case_images: cureus-0015-00000033635-i03.jpg
case_images: PMC9912359_01_cureus-0015-00000033635-i03.jpg
case_images: FIG3