La dificultad del diagnóstico precoz de seudoacalasia de origen tumoral

Bustamante, Mario; Devesa, F; Ferrando, M. José Soneira; Borghol, Amne

doi:10.1016/s0210-5705(01)70143-4

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…In this type of pseudoachalasia, the mechanisms proposed to explain the clinical features of pseudoachalasia include a circumferential mechanistic obstruction of the distal esophagus or malignant infiltration that destroys inhibitory neurons within the myenteric plexus of the esophageal wall. 5 6 In our case, pseudoachalasia was caused by a rare pancreatic cancer beyond the EG junction, and the lesson from that was to not consider the EG area or EG junction tumors alone when diagnosing secondary achalasia.…”

Section: Introductionmentioning

confidence: 77%

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation

et al. 2015

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Secondary achalasia or pseudoachalasia is a rare esophageal motor abnormality, which mimics primary achalasia; it is not easily distinguishable from idiopathic achalasia by manometry, radiological examination, or endoscopy. Although the majority of reported pseudoachalasia cases are associated with neoplasms at or near the esophagogastric (EG) junction, other neoplastic processes or even chronic illnesses such as rheumatoid arthritis can lead to the development of pseudoachalasia, for example, mediastinal masses, gastrointestinal (GI) tumors of the liver and biliary tract, and non-GI malignancies. Therefore, even if a patient presents with the typical findings of achalasia, we should be alert to the possibility of other GI malignancies besides EG tumors. For instance, pancreatic cancer was found in the case reported here; only four such cases have been reported in the literature. A 47-year-old man was admitted to our center with a 3-month history of dysphagia. His endoscopic and esophageal manometric findings were compatible with primary achalasia. However, unresponsiveness to diverse conventional achalasia treatments led us to suspect secondary achalasia. An active search led to a diagnosis of pancreatic mucinous cystadenocarcinoma invading the gastric fundus and EG junction. This rare case of pseudoachalasia caused by pancreatic carcinoma emphasizes the need for suspecting GI malignancies other than EG tumors in patients refractory to conventional achalasia treatment.

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Section: Introductionmentioning

confidence: 77%

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation

et al. 2015

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Pseudoachalasia: A case series and analysis of the literature

Gockel

Eckardt

Schmitt

et al. 2005

Scandinavian Journal of Gastroenterology

108

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Transendoscopic miniprobe and cardial stenosis

Abad

Varas

Barniol

et al. 2006

Rev. esp. enferm. dig.

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A 67-year-old male, an ex-smoker with a history of chronic bronchitis, heartburn, type-2 diabetes mellitus, and prostatic hypertrophy presents to hospital for assessment of dysphagia to both solids and liquids.He is endoscopically diagnosed with distal esophageal stenosis with cardial-level ulceration, which suggests a reflux-related peptic lesion with negative biopsies; an initial dilation using bougies is attempted. A month later a new dilation for restenosis is performed, and further endoscopic biopsies still showed no malignity. He was admitted for severe cardial stenosis assessment.Echoendoscopy using a 12.5 MHz (2 mm in diameter, less than 30 mm in penetration) miniprobe within the distal esophagus detected a round though asymmetric, submucosal hypoechogenic mass (arrows) involving the submucosal and muscularis propria layers (linitis-type carcinoma), or the muscularis propria layer (leiomyosarcoma) with no adenopathies (Fig. 1).With this information, both a computerized tomographic (CT) scan and an endoscopy were performed. The CT scan showed a mass suggestive of distal esophageal neoplasm.Videogastroscopy demonstrated a stenotic area that did not allow the endoscope through. It was dilated using bougies 7 mm and 10.5 mm in diameter. Biopsies performed still were repeatedly negative.A surgical procedure is decided upon, and an intrathoracic esophago-gastrectomy and left lateral thoracotomy is carried out, with a diagnosis of cardial neoplasm with esophageal involvement. Pathology offered a diagnosis of intestinal-type cardial adenocarcinoma (Fig. 2) infiltrating the whole of the gastric wall and involving the submucosal, muscularis, and periesophageal fat layers. Perineural, vascular, and lymphatic involvement was extensive. Adenocarcinoma metastases were seen in 1/21 resected lymph nodes. pT3-N1-M0.Cases of tumor-related pseudoachalasia have been recently reported in our country (1,2). The authors state that "endoscopy must be the technique of choice for the early diagnosis of tumor-related pseudoachalasia in patients under assessment for suspected primary esophageal motor disorder" (3).

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La dificultad del diagnóstico precoz de seudoacalasia de origen tumoral

Cited by 3 publications

References 6 publications

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation

Pseudoachalasia: A case series and analysis of the literature

Transendoscopic miniprobe and cardial stenosis

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