Presentation
Presented with progressive dysphagia, dyspnea and cough. History of tobacco chewing for more than 40 years.
Patient Data
Opacified left hemithorax.
On barium study there is hold up of barium column and tapering of esophageal lumen. There is marked narrowing of mid esophagus with few mucosal irregularities.
There is abnormal heterogeneously enhancing circumferential mural thickening of infracarinal and infracardiac lower thoracic esophagus with a significant luminal compromise.
Another lymph nodal lesion is encroaching the left main bronchus proximal to its further division resulting in collapse and consolidation of the left lung.
There is thrombosis of left pulmonary artery with associated gross left pleural effusion and mild pericardial effusion.
Case Discussion
90% of all primary esophageal neoplasms are squamous cell carcinoma. Dysphagia and weight loss are classic presenting symptoms. At the time of presentation (by the time symptoms develope) lumen of esophagus reduces by 50% of its normal caliber.
Squamous cell carcinoma may directly invade adjacent structures i.e. trachea, bronchi, lungs, pericardium and diaphragm and may spread to lymph nodes in the mediastinum, neck and upper abdomen.
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