Small Cell Carcinoma of the Esophagus in a Patient with Longstanding Primary Achalasia

Achalasia is believed to be a predisposing factor for the development of esophageal cancer. Small cell carcinoma of the esophagus is a rare neoplasm, with fewer than 150 cases having been reported in the world literature, and it has been described only once previously in a patient with longstanding achalasia. We describe a case of an 85-yr-old woman with long-term primary achalasia who developed primary small cell carcinoma of the esophagus. We hypothesize that this patient's recurrent, worsening dysphagia is related to a paraneoplastic phenomenon. We discuss this association and review the literature.     

Achalasia of the Esophagus in Association with Renal Cell Carcinoma

A case of secondary achalasia due to renal cell carcinoma is presented. The patient presented with typical clinical, radiologic, and manometric features of achalasia, and was found to have a renal cell carcinoma with metastases to lymph nodes in the region of the cardioesophageal junction. Direct esophageal involvement could not be demonstrated, however. Complete symptomatic remission was obtained with a single hydrostatic balloon dilatation of the cardioesophageal junction and was maintained until the patient's death 7 months later, perhaps as a result of regression of paraesophageal nodal metastases following radiotherapy, immunotherapy, and chemotherapy.     

Primary Squamous Cell Carcinoma of the Stomach

Primary squamous cell carcinoma of the stomach is a rare lesion. Fewer than 80 such cases are found in the literature. The present case meets strict criteria and, despite direct extension into the liver, an aggressive surgical resection followed by chemotherapy seems to have effected a cure.     

Development of Squamous Cell Carcinoma of the Esophagus after Endoscopic Variceal Sclerotherapy

We describe the case of a 45-yr-old white male with portal hypertension and presumed Laennec's cirrhosis who developed squamous cell carcinoma of the esophagus 8 months after completion of a course of endoscopic variceal sclerotherapy. The epidemiology and natural history of esophageal cancer and their relationship to our patient are analyzed. This report emphasizes that squamous cell carcinoma of the esophagus should be considered in the differential diagnosis of postsclerotherapy dysphagia. Further studies will be required to determine whether or not esophageal variceal sclerotherapy is associated coincidently or causally with the development of squamous cell carcinoma of the esophagus in patients at increased risk for this condition.     

Mucoepidermoid Carcinoma of the Esophagus

The esophageal tumor which occurred in a 53-year old female and was histologically similar to the salivary mucoepidermoid carcinoma, showed local invasion at autopsy. No distant metastasis was noted. Our literature review showed invasive and metastatic nature of the tumor. Submucosal location of the tumor in our case supported the proposed origin of the neoplasm from the esophageal gland.     

Varicoid Carcinoma of the Esophagus

A patient with varicoid carcinoma of the esophagus is reported. These tumors differ from classical esophageal carcinoma and have some resemblance to esophageal varices in their radiological and endoscopic appearances. Dysphagia is generally not the presenting symptom. The histological picture in our patient was that of a poorly differentiated adenocarcinoma with areas of signet-cell carcinoma. This is an exceptional finding since all previously reported cases of varicoid carcinoma of the esophagus have been squamous cell carcinomas.     

Achalasia Associated with Squamous Cell Carcinoma of the Esophagus: A Case Report

A case of achalasia associated with squamous cell carcinoma of the esophagus is presented. Microscopic examination of the resected esophagus demonstrated abundant nerve fibers hut absent ganglion cells throughout the tumor-involved segment. This finding is believed to be the cause of achalasia in this patient.     

Primary Tuberculosis of the Esophagus

A case of primary tuberculosis of the esophagus is presented in an Asian patient. This is a rare site for tuberculosis and mimicked the appearance of a carcinoma.     

Carcinoma of the Esophagus and Hypercalcemia

Hypercalcemia was found in 19 (28%) of 67 patients with cancer of the esophagus. There was no evidence of bone metastases in 14 (20%) of the patients with hypercalcemia. The location of the lesion (upper, middle or lower esophagus) appears to have no bearing on the clinical features in this condition and the association of hypercalcemia with esophageal malignancy, even in the absence of bone metastases, should be recognized.