Abstract
Esophageal cancer is an aggressive and highly lethal malignancy that has a high death-to-incidence ratio approaching 0.90. We present a 60-year-old man with a history of Barrett's esophagus, presented with dysphagia. An upper endoscopy with biopsy confirmed invasive esophageal adenocarcinoma (EAC). Workup, including positron emission tomography scan, showed no evidence of metastasis. A preoperative colonoscopy showed a nodule in the ascending colon that was proven later to be a metastatic lesion from the esophageal primary tumor. Esophageal adenocarcinoma with an isolated colonic metastasis is an extremely rare presentation of esophageal metastasis. These metastatic lesions may not be detected by the positron emission tomography scan.