Early cancer in achalasia

Abstract

Achalasia patients with more than 20 years of evolution, enlarged esophagus with 'knees' and with marked retention must be considered to be of high risk for developing cancer. In this group, the surveillance with endoscopy and lugol vital staining or brush cytology is justified. Other common risk factors of esophageal cancer that must be considered are patients aged over 60 years who are smokers and regular consumers of alcohol.

Oesophagitis is common in patients with achalasia after pneumatic dilatation

“…This is probably due to chronic inflammation and hyperplasia of the epithelium in response to stasis of food and fluid. 10 In oesophageal resection specimens from patients with achalasia and oesophageal squamous cell carcinoma, a marked hyperplasia was found together with multiple dysplastic foci, which findings supports this hypothesis.…”

“…Results 251 patients were followed for a mean values of 8.4 years (range: . The average number of endoscopies with biopsy sample sets per patient was 4 (range: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Three patients had no histological signs of oesophagitis throughout follow-up, 139 had oesophagitis grade 1, 49 oesophagitis grade 2 and 60 grade 3.…”

Implications of genetic variability of Trypanosoma cruzi for the pathogenesis of Chagas disease

“…Such factors can favor the development of epithelial dysplasia, culminating in chronic esophagitis affecting the entire esophageal mucosa. This may be the first step in the development of squamous-cell esophageal carcinoma, which is 33 times more frequent in these patients than in the general population 70 and whose incidence varies from 2% to 8.6% 49,71 .…”

Achalasia Complicated by Multiple Intramucosal Carcinomas: Report of a Case

“…Furthermore, achalasia is considered to be a precancerous condition, with a reported incidence at 2%-9.2%. [15][16][17][18][19] Achalasia may be caused by chemical stimuli due to the chronic retention of saliva and food in the esophagus, [20][21][22] and the rate of carcinogenesis is particularly high in sigmoid-type achalasia where the intestinal contents are stagnant. 23 In addition, a p53 protein mutation study of the esophageal mucosa in patients with achalasia suggests that the entire esophagus may be in a precancerous state.…”