Oesophageal cancer

Case contributed by Dr Prashant Mudgal

Presentation

65 year old male presented with history of dysphagea which was progressive, dyspnoea and cough. Patient has a history of tobacco chewing for more than 40 years.

Patient Data

Age: 65
Gender: Male
Modality: X-ray

Opacified left hemithorax

Modality: Fluoroscopy

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.

Modality: CT

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. Dysphagea 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 calibre.

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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Case Information

rID: 22245
Case created: 22nd Mar 2013
Last edited: 29th Mar 2017
Tag: pm
Inclusion in quiz mode: Included

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