Presentation
Dysphagia.
Patient Data
Circumferential increased wall thickness due to tumoral infiltration is present at the distal esophagus and esophagogastric junction, measuring about 8 cm in length. The contact arch between the mass and adjacent aorta is more than 90 degrees, suggesting local invasion.
A migrated oesophagal stent is seen within the stomach.
On the portal venous phase, central uniform hypoattenuation is present in the spleen, with vessels traversing through it and peripheral enhancement of the splenic parenchyma that becomes less obvious on delayed images. A small calcified focus is also evident in the spleen.
Several dominant lymph nodes are seen in the left axillary regions.
A few non-enhanced simple cortical cysts are seen in both kidneys.
Degenerative changes such as osteophytosis are seen in the thoracolumbar spine.
Scoliosis with rightward convexity is seen in the thoracolumbar spine.
Case Discussion
This is a pathology-proven distal esophageal adenocarcinoma with migrated stent into the stomach.
Esophageal stents are widely used for the palliative treatment of inoperable esophageal malignancies. The main complications associated with esophageal stents include pain and bleeding, stent migration, tumor overgrowth and rarely esophageal perforation.
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