Concurrent manifestations of Horner’s syndrome and esophageal metastasis of breast cancer: case report of a young woman after a period of non-adherence to treatment: a case report

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Concurrent manifestations of Horner’s syndrome and esophageal metastasis of breast cancer: case report of a young woman after a period of non-adherence to treatment: a case report


JournalJournal of Medical Case Reports
Article typeJournal research article – Case report / series
Publication date – Apr – 2021
Authors – Sumadi Lukman Anwar, Widya Surya Avanti, Lina Choridah, Ery Kus Dwianingsih, Herjuna Hardiyanto , Teguh Aryandono
KeywordsBreast Cancer, diagnosis, Esophageal metastasis, Horner’s syndrome, Low adherence
Open access – Yes
SpecialityGeneral surgery, Surgical oncology
World region South-eastern Asia
Country: Indonesia
Language – English
Submitted to the One Surgery Index on April 17, 2021 at 10:46 pm
Abstract:

Background
Esophageal involvement and Horner’s syndrome are rare manifestations of breast cancer distant metastases that can pose a significant challenge in diagnosis and treatment. In addition to the more aggressive behavior of breast cancer diagnosed in young women, non-adherence to treatment is associated with increased risk of distant metastasis.

Case presentation
A 36-year-old Javanese woman presented to our institution with dysphagia, hoarseness, and frequent hiccups. In the 6 weeks prior to the current admission, the patient also reported tingling in the neck and shoulder, anhidrosis in the left hemifacial region, and drooping of the upper left eyelid. She was previously managed as tuberculoid laryngitis. Plain X-rays showed burst fractures of the cervical vertebrae and slight pleural effusion. Laryngoscopy revealed bowing of the vocal cords and liquid residue in the vallecula that was reduced upon chin tuck. Esophageal metastasis was confirmed with endoscopy showing thickening of the wall and positive cytology swab with ductal malignant cells. The patient had a history of breast cancer with a period of loss to follow-up of 4 years.

Conclusions
Physicians should consider potential distant metastasis of breast cancer to the esophagus and sympathetic nervous system of the neck particularly in a high-risk woman with presentation of dysphagia and manifestations of Horner’s syndrome.

OSI Number – 21020

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