Hematemesis melena in a young male patient with suspected of esophageal cancer: a rare case report
Downloads
Background: Esophageal cancer (EC) in Indonesia is a rare case. Generally, EC cases occur in people over 50 years of age. In younger patients, it is a rare condition and is usually associated with a poor prognosis. Early-stage EC is generally asymptomatic, so it is often diagnosed late. The most common symptom is dysphagia. Upper gastrointestinal bleeding (UGIB) symptoms in EC are less common and related to emergencies. This study aims to provide an overview of the symptoms and diagnostic approach of EC in young patients.
Case presentation: A 19-year-old male patient presented to the emergency department with complaints of black stools and hematemesis. The patient also experienced a weight loss of 8 kg over the past three months. Previously, the patient frequently complained of epigastric pain and heartburn but had never sought medical treatment. Initial laboratory tests revealed severe anemia. An abdominal ultrasound showed multiple nodules in the liver, raising suspicion of metastasis, and endoscopic findings revealed a mass in the distal third of the esophagus.
Conclusions: EC should be considered in young patients presenting with warning signs such as UGIB, progressive weight loss, dysphagia, and anemia. A comprehensive history-taking, physical examination and prompt EGD are essential for diagnosing EC.
1. Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019;94(4):697-703. doi:10.1016/j.mayocp.2019.01.022
2. Global Cancer Observatory. Oesophagus. https://gco.iarc.who.int/media/globocan/factsheets/cancers/6-oesophagus-fact-sheet.pdf. Accessed December 5, 2024
3. Donohoe CL, MacGillycuddy E, Reynolds J V. The impact of young age on outcomes in esophageal and junctional cancer. Diseases of the Esophagus. 2011;24(8):560-568. doi:10.1111/j.1442-2050.2011.01183.x
4. Liu CQ, Ma YL, Qin Q, et al. Epidemiology of esophageal cancer in 2020 and projections to 2030 and 2040. Thorac Cancer. 2023;14(1):3-11. doi:10.1111/1759-7714.14745
5. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34. doi:10.3322/caac.21551
6. Codipilly DC, Sawas T, Dhaliwal L, et al. Epidemiology and outcomes of young-onset esophageal adenocarcinoma: An analysis from a population-based database. Cancer Epidemiol Biomarkers Prev. 2021;30(1):142-149. doi:10.1158/1055-9965.EPI-20-0944
7. Dawsey SP, Tonui S, Parker RK, et al. Esophageal cancer in young people: A case series of 109 cases and review of the literature. PLoS One. 2010;5(11). doi:10.1371/journal.pone.0014080
8. Lakkanna A, Gopalam V, Rajender G, Manna S. Squamous Cell Carcinoma of the Esophagus in an Adolescent: A Case Report. Cureus. 2024;16(9):1-6. doi:10.7759/cureus.68660
9. Dufera RR, Osman A, Nnamani I, Tolu-Akinnawo O, Smoot D. The Rare Case of Esophageal Cancer Presenting With Hematemesis in a 29-Year-Old Adult. Cureus. 2023;15(6):1-4. doi:10.7759/cureus.39881
10. Then EO, Lopez M, Saleem S, et al. Esophageal cancer: An updated surveillance epidemiology and end results database analysis. World J Oncol. 2020;11(2):55-64. doi:10.14740/WJON1254
11. Espe F, Yamul R. Esophageal Adenocarcinoma in a 23 Year Old Male: A Case Report. Clin Gastroenterol Hepatol. 2021;5(1):1-4. https://www.imedpub.com/clinical-gastroenterology-and-hepatology/
12. Sawas T, Manrique GC, Iyer PG, Wang KK, Katzka DA. Young Adults With Esophageal Adenocarcinoma Present With More Advanced Stage Tumors and Have Shorter Survival Times. Clinical Gastroenterology and Hepatology. 2019;17(9):1756-1762. doi:10.1016/j.cgh.2018.09.031
13. Song EY, Naffouje SA, Saeed S, et al. Esophageal cancer in young patients: does age affect treatment course and outcomes? Ann Esophagus. 2021;49(35):1-15. doi:10.21037/AOE-20-92
Copyright (c) 2025 MEDISAINS
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
