12th May 2024

A 59-year-old man presents with a history of progressive difficulty swallowing, retrosternal pain, and significant weight loss over the last 5 months.

A 59-year-old man presents with a history of progressive difficulty swallowing, retrosternal pain, and significant weight loss over the last 5 months. He has a long-standing history of gastroesophageal reflux disease and Barrett’s oesophagus. An endoscopy reveals an obstructive mass in the lower third of the oesophagus, and biopsy confirms adenocarcinoma. PET-CT imaging shows metastatic lesions in the liver.

Which is the most likely route by which this tumour spread to the liver?