男患,74岁.因右胸部包块40天,梗噎10天就诊.患者40天前洗澡时无意中发现右胸部有一核桃大小的皮下结节,不红不痛,在当地给予抗生素治疗.近10天进干食有梗噎感,皮下结节增至鸡蛋大.查体:神志清楚,慢性病容,消瘦,浅表淋巴结末触及,心肺无异常.右侧第四肋间腋前线处可触及一皮下包块,约鸡蛋大小,质中,表面欠光滑,边缘尚清楚,轻度压痛,包块中心红肿、糜烂。无波动感。胸透双肺无异常发现.胸部包块穿刺涂片细胞学检查发现鳞癌细胞,食道吞钡检查提示食道下段癌。讨论内脏恶性肿瘤皮肤转移发生率为1.3～4.4%.食道癌的远处转移有淋巴及血行两种途径, The male patient, 74 years old, had a mass of 40 days in the right chest and suffered a ten-day treatment. The patient inadvertently found a walnut-sized subcutaneous nodule in the right chest, which was not red and painless. He was given antibiotic treatment locally. In the past 10 days, dry food has a stench of sensation, and subcutaneous nodules increase to large eggs. Physical examination: conscious, chronic disease, weight loss, superficial lymph node touch, no abnormalities of heart and lung. The right fourth intercostal tendon line can be Touched a subcutaneous mass, about egg size, quality, the surface is less smooth, the edge is still clear, mild tenderness, mass swelling in the center, erosion. No sense of volatility. No chest chest abnormalities found. Chest mass puncture smear cytology found squamous cell carcinoma, esophageal swallowing examination prompted lower esophageal cancer. Discussion The incidence of cutaneous metastasis of visceral malignancies was 1.3-4.4%. The distant metastases of esophageal cancer were lymphatic and bloody.