Presentation
Dysphagia.
Patient Data
There is proximal and middle esophageal dilatation accompanied by distal irregular severe narrowing with shouldering appearance suggestive for pseudoachalasia due to tumoral infiltration of the distal esophagus.
Wall thickening due to tumoral infiltration was seen at the distal esophagus, esophagogastric junction, gastric cardia and subcardia. The patient underwent endoscopic biopsy and histopathologic evaluation confirms adenocarcinoma.
A few enlarged lymph nodes are present in the perigastric region.
Three hypodense lesions with peripheral density, spotty enhancement was seen in the liver. The largest one is 23 mm and is located at 7th segment. On delayed phase images the attenuated areas spread through the masses. The density of the lesion is almost the same as that of aorta in all phases. Features are compatible with hemangioma.
Case Discussion
Pseudoachalasia is an achalasia-pattern dilatation of the esophagus due to the narrowing of the distal esophagus from causes other than primary denervation.
One of the most common causes is malignancy with extension in the lower esophagus.
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