Metastasis pathways and symptoms of esophageal cancer

The early lesions of esophageal cancer are confined to the mucosal surface, and gradually involve the entire layer in the middle and late stages and infiltrate and spread to the surrounding tissues. The main metastatic pathway of esophageal cancer is lymphatic metastasis, which first involves the submucosal lymph nodes, then develops to the lymph nodes in the larynx, neck, supraclavicular, trachea, and finally involves the abdominal aortic fat and celiac plexus lymph nodes. A small number of esophageal cancers metastasize through direct infiltration and blood flow.

Metastatic symptoms of esophageal cancer can be divided into organ metastasis symptoms and symptoms caused by cancer metastasis. When organ metastasis occurs, such as metastasis to important organs such as the lungs, liver, and brain, patients may experience dyspnea, jaundice, ascites, coma, and other unique symptoms of the corresponding organs. Symptoms caused by cancer metastasis are even more common, such as cancer cells invading the recurrent laryngeal nerve, causing vocal cord paralysis and hoarseness; tumor compression and invasion of the trachea and bronchi, causing shortness of breath and irritating dry cough. If the trachea is penetrated, esophageal-tracheal fistula may occur; invasion of the phrenic nerve, causing diaphragmatic paralysis; invasion of the vagus nerve, accelerating the heart rate; invasion of the brachial plexus, causing arm soreness, pain, and paresthesia; compression of the superior vena cava, causing superior vena cava compression syndrome; tumor compression of the sympathetic ganglia, resulting in sympathetic nerve paralysis symptoms, namely Horner syndrome.