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 24 October 2017

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GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

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GastroenterologyEsophagus

Malignant diseases

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Adenocarcinoma of the esophagus.
A 49-year old man with an adenocarcinoma confined to the lower third of the esophagus. CT imaging studies of the chest and abdomen did not show any evidence of spread of the disease. The tumor responded well to neo-adjuvant chemoradiotherapy. He then underwent esophagectomy. Three months after surgery he presented with a two day history of dizziness, vomiting and feeeling unwell. A CT scan of his head showed at least six metastatic deposits.

Comment: Carcinoma of the esophagus may metastasize anywhere, however the usual sites are local spread, the lungs and the liver. As part of the initial management of patients with esophageal cancer, imaging studies include the chest and abdominal cavities - but not the head, as metastatic disease to the brain is uncommon. Such a case begs the question of whether the whole body should be scanned in the initial assessment of this condition.

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Peter Devitt, Adelaide, Australia

Adenocarcinoma of the esophagus.

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