Synchronous rectal and esophageal cancer treated with chemotherapy followed by two-stage resection

Figure 1 Computed tomography before treatment showed multiple liver metastases (arrows) and a primary upper rectal tumor that had invaded the urinary bladder. A, B: Multiple liver metastases; C, D: A primary upper rectal tumor.

Figure 2 Colonoscopy revealed a circumferential lesion in the upper rectum and the lumen was almost completely obstructed.

Figure 3 On esophagogastroscopy, a depressed lesion with a little surrounding elevation was observed in the mid-thoracic esophagus, and biopsy resulted in a diagnosis of squamous cell carcinoma. A: Esophagogastroscopy before treatment revealed a shallow depressed area in the middle third of the thoracic esophagus; B: After 6 cycles of chemotherapy, the esophageal lesion had flattened slightly, and there was good disease control.

Figure 4 The computed tomography findings after 6 cycles of mFOLFOX6 plus cetuximab chemotherapy showed a good response in both the liver metastases (arrows) and primary lesion. A, B: Liver metastases; C, D: Primary lesion.