Gut Liver.  2012 Apr;6(2):275-279.

Primary Squamous Cell Carcinoma of the Liver Initially Presenting with Pseudoachalasia

• Choi MK
• Kim GH
• Song GA
• Nam HS
• Yi YS
• Ahn KH
• Kim S
• Kim JY
• Park DY

Abstract

Pseudoachalasia secondary to primary squamous cell carcinoma (SCC) of the liver is extremely rare and has not been reported until now. Here, we report a unique case of primary SCC of the liver initially presenting with progressive dysphagia along with short periods of significant weight loss. A 58-year-old man initially presented with progressive dysphagia along with significant weight loss over brief periods of time. The radiographic and manometric findings were consistent with achalasia. Subsequent esophagogastroduodenoscopy revealed a moderately dilated esophagus without evidence of neoplasm or organic obstruction. However, firm resistance was encountered while traversing the esophagogastric junction (EGJ), although no mucosal lesion was identified. Due to the clinical suspicion of the presence of a malignant tumor, endoscopic ultrasonography (EUS) and computed tomography scans of the chest and abdomen were obtained. A huge hepatic mass with irregular margins extending to the EGJ was found. EUS-guided fine-needle aspiration was performed, and the mass was diagnosed as a primary SCC of the liver by immunohistochemical staining.

Keyword

Esophageal achalasia; Squamous cell carcinoma; Liver

MeSH Terms

Abdomen
Biopsy, Fine-Needle
Carcinoma, Squamous Cell
Deglutition Disorders
Endoscopy, Digestive System
Endosonography
Esophageal Achalasia
Esophagogastric Junction
Esophagus
Humans
Liver
Middle Aged
Thorax
Weight Loss