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Unusual presentation of more common disease/injury
CASE REPORT
Achalasia leading to diagnosis of adenocarcinoma of the oesophagus
  1. Jonathan Segal1,
  2. Ayodele Lagundoye2,
  3. Martyn Carter2
  1. 1St Mark's Hospital, Harrow, UK
  2. 2Gastroenterology, Lister Hospital, Stevenage, UK
  1. Correspondence to Dr Jonathan Segal, jonathansegal{at}doctors.org.uk

Summary

A 50-year-old male with a 7 month history of progressive dysphagia to solids then subsequently to liquids. He underwent a diagnostic gastroscopy which was normal. A further barium swallow suggested achalasia. He was referred to a tertiary centre, where he underwent pH and manometry studies which confirmed a diagnosis of achalasia. He was referred for a laparoscopic cardiomyotomy, and at surgery there was a suspected tumour at the gastro-oesophageal junction. A follow-up endoscopy with biopsies was normal. Following this, a positron emission tomography scan showed T3 distal oesophageal cancer with no nodal involvement or distal metastasis. An attempt at oesophagectomy was performed, but at operation there was locally advanced carcinoma infiltrating the coeliac axis. He is currently undergoing palliative chemotherapy.

  • Gastrointestinal system
  • Oesophagus
  • Oesophageal cancer

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2017-219386

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    Footnotes

    • Contributors JS did the initial literature search around the topic, contacted the patient for consent and discussion. He gathered all the data and analysed the data. He wrote the manuscript and edited it. AL helped refine the manuscript. MC was the primary physician of the patient and helped with the planning of the manuscript including conception and design. He also helped with refinement of the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.