Achalasia secondary to nongastrointestinal malignancies

Feczko, Peter J.; Halpert, Robert D.

doi:10.1007/bf01893111

Cited by 21 publications

(6 citation statements)

References 10 publications

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“…It accounts for 2-4% of cases of achalasia3,4 and has been reported with various types of malignancies. Nearly 75% of the patients with secondary achalasia are found to have underlying carcinoma of the cardia, but secondary achalasia may also be caused by SCC of the esophagus,5 or by other malignant tumors that metastasize to the mediastinum or the GE junction, including carcinoma of the lung, breast, pancreas, uterus, and prostate gland 6-8…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Submucosal Invasion of Esophageal Squamous Cell Carcinoma Mistaken as Primary Achalasia

Park¹,

Park²,

Kim³

et al. 2010

J Neurogastroenterol Motil

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Secondary achalasia due to submucosal invasion of esophageal squamous cell carcinoma (SCC) is a very rare condition. Here, we report a case of secondary achalasia diagnosed after distal esophagectomy, initially mistaken as primary achalasia. A 51-year-old man presented with progressive dysphagia for 2 months and mild weight loss. A barium swallow study, endoscopy, and manometry showed typical findings of primary achalasia. Pneumatic dilatation was performed, but esophageal perforation occurred as a complication. During surgical repair, no abnormalities around distal esophagus were found, and intraoperative esophageal biopsy revealed only inflammatory cells. During the following 8 months, the patient suffered from dysphagia caused by recurrent esophageal obstruction several times although of repeated balloon dilatation and esophageal stent insertion. Finally, he received a distal esophagectomy. The postoperative pathology revealed SCC at the distal esophagus and esophagogastric junction.

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Section: Discussionmentioning

confidence: 99%

An Unusual Case of Submucosal Invasion of Esophageal Squamous Cell Carcinoma Mistaken as Primary Achalasia

Park¹,

Park²,

Kim³

et al. 2010

J Neurogastroenterol Motil

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“…The prevalence of pseudoachalasia is considered to be in the 2–4% range among patients with manometric findings suggestive of achalasia, with less than 100 cases reported in the literature so far 2,3,17,18 . Primary gastric cancer is usually recognized as the most common malignancy causing pseudoachalasia, but also liver, lung, genital, colon, pancreas, breast cancer and metastases from unknown primaries have been reported in association with achalasia 1,3,4,7–15,18 . Benign causes of pseudoachalasia are extremely rare in Europe and North America, but in South America and in developing countries Chagas’ disease may mimic achalasia.…”

Section: Discussionmentioning

confidence: 99%

“…The difficulty of differentiating achalasia from pseudoachalasia is well known 2–17 . Older age, short clinical history and significant weight loss in a short period of time are usually considered suggestive of pseudoachalasia.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,17,18 Primary gastric cancer is usually recognized as the most common malignancy causing pseudoachalasia, but also liver, lung, genital, colon, pancreas, breast cancer and metastases from unknown primaries have been reported in association with achalasia. 1,3,4,[7][8][9][10][11][12][13][14][15]18 Benign causes of pseudoachalasia are extremely rare in Europe and North America, but in South America and in developing countries Chagas' disease may mimic achalasia. Two cases of pseudoachalasia in patients with pancreatic carcinoma and two cases in patients with metastases from breast cancer have been described in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,[4][5][6] However, it has been reported that processes other than esophagogastric cancers may lead to the development of pseudoachalasia, such as mediastinal masses or metastatic lesions located at the GEJ from carcinomas originating in the lung, pancreas and other organs ( Table 1). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] We present three cases of pseudoachalasia in which the primary cause of the disease was not an esophagogastric cancer.…”

Section: Introductionmentioning

confidence: 99%

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Pseudoachalasia: not only esophago-gastric cancer

Portale

Costantini

Zaninotto

et al. 2007

Diseases of the Esophagus

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Pseudoachalasia is a rare clinical entity which has clinical, radiographic and manometric features often indistinguishable from achalasia. A small primary adenocarcinoma arising at the gastroesophageal junction or a tumor of the distal esophagus are the most frequent causes. Rarely, processes other than esophagogastric cancers may lead to the development of pseudoachalasia. We present three cases of pseudoachalasia in which the primary cause of the disease was not an esophagogastric cancer. The causes were a pancreatic carcinoma, a breast cancer and an histiocytosis X. Aspects of these three patients' diagnostic and therapeutic course are discussed in detail.

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Pseudoachalasia after radical gastrectomy

Yeoman

Grundy

Parker

et al. 1989

Journal of British Surgery

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Case reportsanastomosis with a Roux-en-Y loop was fashioned. Histological examination of the resected specimen showed a moderately differentiated adenocarcinoma. The resected margins were free of tumour but lymph nodes from the greater curve and lesser curve contained metastatic tumour.The patient remained well until 6 months later when he was readmitted to hospital with postprandial vomiting. There was no dysphagia and appetite was preserved, although weight loss of 5 kg over the preceding month was documented.A barium meal demonstrated a functional obstruction of the lower oesophagus with a smoothly tapered narrow segment, which opened only when an adequate column of barium produced sufficient pressure ( Figure I); the appearances resembled achalasia. There was no evidence of stricture at the anastomosis or of tumour recurrence and barium passed freely into the jejunal loop.At endoscopy the lower oesophagus was thought to be slightly rigid but otherwise normal. The jejunum was entered easily and appeared normal. Biopsies from the anastomosis and adjacent mucosa showed no evidence of malignancy or inflammation.Balloon dilatation of the distal oesophagus was performed and the lower oesophagus dilated readily. A repeat barium swallow 6 days later showed some improvement with less lower oesophageal spasm, although the appearances still resembled achalasia.A small bowel meal via a tube introduced into the efferent loop suggested extrinsic compression I5 cm from the anastomosis site. At laparotomy there was extensive peritoneal disease with encasement of the lower end of the oesophagus by plaque-like tumour. There was no possibility of palliative surgery. The patient died postoperatively and post-mortem examination was not performed. We report the case of a patient who had a radical total gastrectomy with oesophagojejunostomy for an adenocdrcinoma of the stomach. This patient subsequently demonstrated radiological and endoscopic features of achalasia, although these were not present at the time of presentation of the carcinoma. Case historyA 69-year-old man presented with breathlessness and anaemia. A double-contrast barium meal revealed a tumour high on the lesser curve of the stomach, which was confirmed by endoscopic biopsy to be an adenocarcinoma.A radical total gastrectomy, splenectomy and distal pancreatectomy with omentectomy was performed. A stapled oesophagojejunal DiscussionPrimary achalasia is a motility disorder of the oesophagus of unknown cause.On barium studies achalasia has characteristic features. There is failure of relaxation of the lower oesophageal sphincter with the lower end showing smooth symmetrical narrowing. In the horizontal position barium does not pass into the stomach, but in the upright position the barium column is retained above the lower oesophageal sphincter until its hydrostatic pressure overcomes the resistance and barium squirts into the stomach. 97

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Achalasia secondary to nongastrointestinal malignancies

Cited by 21 publications

References 10 publications

An Unusual Case of Submucosal Invasion of Esophageal Squamous Cell Carcinoma Mistaken as Primary Achalasia

An Unusual Case of Submucosal Invasion of Esophageal Squamous Cell Carcinoma Mistaken as Primary Achalasia

Pseudoachalasia: not only esophago-gastric cancer

Pseudoachalasia after radical gastrectomy

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