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Advanced Practice

Esophageal Cancer: A Case Study of a Rare Metastatic Esophageal Squamous Cell Carcinoma

Grace Cullen
CJON 2020, 24(4), 352-355 DOI: 10.1188/20.CJON.352-355

The expected pattern of spread in metastatic esophageal squamous cell carcinoma involves the upper torso and thorax. This article presents an unusual instance of an isolated osseous metastasis of esophageal squamous cell carcinoma to the distal bone of the left ankle and describes the contributions of advanced practice nursing assessment and clinical judgment to improve patient outcomes. This case study also highlights comprehensive cancer care by an interprofessional palliative care team.


  • It is important to be aware of typical patterns of metastases but also to maintain a high index of suspicion for unusual sites of metastatic spread.
  • Accurate and timely assessments by advanced practice nurses are essential to appropriate clinical conclusions and disease management.
  • Early and ongoing involvement of a palliative care team promotes patient autonomy, goals-of-care discussions, and advocacy for patient wishes.

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