Esophageal cancer and trachea-esophageal fistula in Achalasia - A case report
Abstract
Achalasia is an idiopathic motility disorder of esophagus which is characterised by an impaired relaxation of the lower esophageal sphincter and decreased motility of the esophageal body.
It is considered as premalignant lesion for development of esophageal cancer. We present a case of
70 year old woman who had dysphagia for 30 years presented with worsening dysphagia for last 2
months, productive cough and significant weight loss. UGI scopy showed ulceroproliferative growth
Full Text:
PDFReferences
Streitz JM Jr, Ellis FH Jr, Gibb SP, Heatley GM. Achalasia and squamouscell carcinoma of the esophagus: analysis of 241 patients. Ann Thorac Surg.
Jun;59(6):1604-9.
Meijssen MA, Tilanus HW, van Blankenstein M, Hop WC, Ong GL.
Achalasia complicated by oesophageal squamous cell carcinoma: a
prospective study in 195 patients. Gut. 1992 Feb;33(2):155-8
Brucher BL, Stein HJ, Bartels H, Feussner H, Siewert JR. Achalasia and
esophageal cancer: incidence, prevalence, and prognosis. World J Surg.
Jun;25(6):745-9
ASGE guideline: the role of endoscopy in the surveillance of premalignant
conditions of the upper GI tract. Gastrointestinal Endoscopy Volume 63, No.
: 2006
A.O Adeyinka ,P.O Ibinaiye. Esophageal carcinoma complicating
achalasia, 25 years after esophagomyotomy. Nigerian journal of surgical
research,Vol 7 No 1-2, 2005::209 – 213
with tracheo-esophageal fistula in upper esophagus and dilated, aperistaltic lower esophagus. There
was increased resistance at GE junction. Multiple Biopsies were taken from the growth and
Histopathology showed moderately differentiated squamous cell carcinoma. CECT Thorax showed
heterogenously enhancing thickening of upper esophagus with tracheo-esophageal fistula between
right posterolateral wall of trachea and anterior wall of upper esophagus, dilated distal esophagus
with fluid level, multiple mediastinal lymphadenopathy and consolidation with nodular parenchymal
infiltrates in both lungs. Since patient has stage IV esophageal squamous cell carcinoma, she was
treated with palliative chemotherapy. Malignancy of esophagus in Achalasia is rare but has to be
anticipated in long standing Achalasia, for an early diagnosis curative treatment.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
An initiative of The Tamil Nadu Dr M.G.R. Medical University