{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:18:49Z","timestamp":1788153529167,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small bowel metastasis from primary esophageal carcinoma is a rare occurrence, typically indicative of advanced disease and often presenting with non-specific abdominal symptoms. Failure to consider this possibility in the differential diagnosis may lead to delayed or incorrect management. This article reports the case of a 60-year-old male with small bowel metastasis originating from esophageal squamous cell carcinoma. To better characterize this clinical entity, we also conducted a systematic review of 23 documented cases, analyzing their clinicopathological features, diagnostic approaches, treatment modalities, and prognostic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 60-year-old man presented with small bowel obstruction, ultimately diagnosed as metastatic esophageal squamous cell carcinoma. Surgical resection was followed by combined immunotherapy and chemotherapy, yielding a partial response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review<\/jats:title>\n                    <jats:p>We reviewed 23 published cases, highlighting a strong male predominance (82.6%), jejunal predilection, and a median survival of only 6 months post-diagnosis. Small bowel metastasis from esophageal carcinoma, though uncommon, represents a challenging clinical scenario often mimicking more common abdominal pathologies. Histopathological confirmation is essential for accurate diagnosis. Early detection and a multidisciplinary treatment approach may correlate with favorable survival trends in these advanced-stage patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Small bowel metastasis should be considered in esophageal cancer patients with acute abdominal symptoms. Histopathological confirmation is crucial, and a multimodal approach may be associated with extended survival trends in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1891441","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:29:16Z","timestamp":1788150556000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Small bowel metastasis from esophageal squamous cell carcinoma: a case series and systematic review of clinical characteristics, tropism, and survival outcomes"],"prefix":"10.3389","volume":"17","author":[{"given":"Mingyu","family":"Zhou","sequence":"first","affiliation":[{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]},{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiwen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaowei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhichao","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junming","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guankao","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yating","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"Jinan University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisheng","family":"Huang","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]},{"name":"Department of Oncology, Maoming People\u2019s Hospital","place":["Maoming, Guangdong, China"]},{"name":"The First School of Clinical Medicine, Southern Medical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v6.i5.112","article-title":"Esophageal cancer: a review of epidemiology, pathogenesis, staging workup and treatment modalities","volume":"6","author":"Napier","year":"2014","journal-title":"World J Gastrointest Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.rxeng.2020.09.004","article-title":"An updated review of the TNM classification system for cancer of the oesophagus and its complications","volume":"63","author":"L\u00f3pez Sala","year":"2021","journal-title":"Radiol (Engl Ed)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.15.5.7501854","article-title":"CT of the esophagus: spectrum of disease with emphasis on esophageal carcinoma","volume":"15","author":"Noh","year":"1995","journal-title":"Radiographics"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19951001)76:7<1120::aid-cncr2820760704>3.0.co;2-w","article-title":"Incidence and distribution of distant metastases from newly diagnosed esophageal carcinoma","volume":"76","author":"Quint","year":"1995","journal-title":"Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1657310","article-title":"Esophageal cancer metastases to unexpected sites: a systematic review","volume":"2017","author":"Shaheen","year":"2017","journal-title":"Gastroenterol Res Pract"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1560011","article-title":"Small bowel metastasis during organ preservation in patients with esophageal squamous cell carcinoma: case report and literature review","volume":"15","author":"Cao","year":"2025","journal-title":"Front Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"213","DOI":"10.14309\/ajg.0000000000001524","article-title":"A rare case of duodenal papilla metastasis from the gastroesophageal junction","volume":"117","author":"Chua","year":"2022","journal-title":"Am J Gastroenterol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-232388","article-title":"Chronic intestinal pseudo-obstruction in a patient with metastatic gastro-oesophageal junction cancer receiving treatment with pembrolizumab","volume":"12","author":"Besaw","year":"2019","journal-title":"BMJ Case Rep"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5107(05)00556-0","article-title":"Esophageal squamous cell carcinoma with metastasis to the ampulla","volume":"62","author":"Sreenarasimhaiah","year":"2005","journal-title":"Gastrointest Endosc"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1519922","article-title":"Esophageal squamous cell carcinoma with colonic and rectal metastases: a rare case report","volume":"15","author":"Yang","year":"2025","journal-title":"Front Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s003300050164","article-title":"Metastatic oesophageal carcinoma presenting as small intestinal ischaemia: imaging findings","volume":"7","author":"Traill","year":"1997","journal-title":"Eur Radiol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198507000-00030","article-title":"Metastatic squamous cell carcinoma from the esophagus occurring as small bowel obstruction","volume":"78","author":"Wang","year":"1985","journal-title":"South Med J"},{"key":"B14","article-title":"Ileal metastases from oesophageal carcinoma causing intestinal obstruction","volume":"51","author":"Neve","year":"2005","journal-title":"J Postgrad Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-3-44","article-title":"Occult solitary submucosal jejunal metastasis from esophageal carcinoma","volume":"3","author":"Lindenmann","year":"2005","journal-title":"World J Surg Oncol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2021.106164","article-title":"Presentation of gastroesophageal junction adenocarcinoma with synchronous metastases at the small intestine. Could treatment with curative intent be considered? a case report","volume":"84","author":"Huang","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-013-0385-5","article-title":"Synchronous solitary small intestinal metastasis from esophageal squamous cell carcinoma: report of a case","volume":"10","author":"Yamana","year":"2013","journal-title":"Esophagus"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/bf00311639","article-title":"Small intestinal metastasis from esophageal carcinoma associated with small intestinal obstruction: report of a case","volume":"26","author":"Yamada","year":"1996","journal-title":"Surg Today"},{"key":"B19","article-title":"Small intestinal metastasis from esophageal squamous cell carcinoma presenting with perforated peritonitis","volume":"40","author":"Chino","year":"2015","journal-title":"Tokai J Exp Clin Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s13691-024-00717-y","article-title":"Carcinoma esophagus with small bowel metastasis: a case report with review of literature","volume":"13","author":"Chandran","year":"2024","journal-title":"Int Canc Conf J"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2018.05.022","article-title":"Small intestinal metastases from esophageal carcinoma presenting as a perforation: a case report and review of the literature","volume":"48","author":"Ono","year":"2018","journal-title":"Int J Surg Case Rep"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9728424","article-title":"Small bowel obstruction caused by small intestinal metastasis secondary to esophageal carcinoma","volume":"2021","author":"Naoshima","year":"2021","journal-title":"Case Rep Surg"},{"key":"B23","article-title":"Diagnosis and differential diagnosis of intestinal obstruction caused by metastatic squamous cell carcinoma of the small intestine: a case report [In Chinese","volume":"30","author":"Lyu","year":"2010","journal-title":"Int J Pathol Clin Med"},{"key":"B24","first-page":"49","article-title":"A case report of small intestinal metastasis from esophageal squamous cell carcinoma [In Chinese","author":"Zhang","year":"1993","journal-title":"J Pract Med"},{"key":"B25","article-title":"A case of esophageal cancer with ileal metastasis [In Chinese","volume":"31","author":"Liu","year":"2023","journal-title":"J Clin Surg"},{"key":"B26","article-title":"A case report of intestinal perforation due to small intestinal metastasis from esophageal squamous cell carcinoma [In Chinese","volume":"26","author":"Wang","year":"2017","journal-title":"Chin J Gastroenterol Hepatol"},{"key":"B27","article-title":"Clinical and pathological features of metastatic tumors of the small intestine: a report of 4 cases [In Chinese","volume":"18","author":"Liao","year":"2012","journal-title":"Chin J Surg Integrated Traditional Western Med"},{"key":"B28","first-page":"38","article-title":"A case of ileal metastasis after esophageal cancer resection [In Chinese","author":"Li","year":"1999","journal-title":"Chin J Clin Oncol"},{"key":"B29","first-page":"416","article-title":"A case of ileal metastasis after resection of esophageal squamous cell carcinoma [In Chinese","author":"Liu","year":"2009","journal-title":"Proc 3rd China Conf Med Oncol Educ Collection"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1097\/jto.0000000000000369","article-title":"Deregulation of SLIT2-mediated Cdc42 activity is associated with esophageal cancer metastasis and poor prognosis","volume":"10","author":"Tseng","year":"2015","journal-title":"J Thorac Oncol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2016.06.015","article-title":"Silencing NKD2 by promoter region hypermethylation promotes esophageal cancer progression by activating Wnt signaling","volume":"11","author":"Cao","year":"2016","journal-title":"J Thorac Oncol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.10860","article-title":"EphA2 overexpression correlates with poor prognosis in esophageal squamous cell carcinoma","volume":"103","author":"Miyazaki","year":"2003","journal-title":"Int J Cancer"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/jto.0b013e31823815d3","article-title":"\u0394Np63 (p40) and thyroid transcription factor-1 immunoreactivity on small biopsies or cellblocks for typing non-small cell lung cancer: a novel two-hit, sparing-material approach","volume":"7","author":"Pelosi","year":"2012","journal-title":"J Thorac Oncol"},{"key":"B35","article-title":"Value of surgical treatment in patients with gastrointestinal metastatic tumors","volume":"33","author":"Wang","year":"1995","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1515\/jtim-2025-0023","article-title":"Advances in the diagnosis and treatment of gastrointestinal tumors under the concept of super minimally invasive surgery","volume":"13","author":"Chen","year":"2025","journal-title":"J Transl Int Med"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.12836","article-title":"Effect of Camrelizumab vs placebo added to chemotherapy on survival and progression-free survival in patients with advanced or metastatic esophageal squamous cell carcinoma: the ESCORT-1st randomized clinical trial","volume":"326","author":"Luo","year":"2021","journal-title":"JAMA"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2111380","article-title":"Nivolumab combination therapy in advanced esophageal squamous-cell carcinoma","volume":"386","author":"Doki","year":"2022","journal-title":"N Engl J Med"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(21)01234-4","article-title":"Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study","volume":"398","author":"Sun","year":"2021","journal-title":"Lancet"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(23)00108-0","article-title":"Tislelizumab plus chemotherapy versus placebo plus chemotherapy as first-line treatment for advanced or metastatic oesophageal squamous cell carcinoma (RATIONALE-306): a global, randomised, placebo-controlled, phase 3 study","volume":"24","author":"Xu","year":"2023","journal-title":"Lancet Oncol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1891441\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:29:21Z","timestamp":1788150561000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1891441\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":40,"alternative-id":["10.3389\/fimmu.2026.1891441"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1891441","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"article-number":"1891441"}}