J Neurogastroenterol Motil.  2010 Apr;16(2):194-198.

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

• Park JH
• Park DI
• Kim HJ
• Cho YK
• Sohn CI
• Jeon WK
• Kim BI

Abstract

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.

Keyword

Achalasia; Squamous cell carcinoma; Balloon dilatation

MeSH Terms

Barium
Biopsy
Carcinoma, Squamous Cell
Deglutition Disorders
Dilatation
Endoscopy
Esophageal Achalasia
Esophageal Neoplasms
Esophageal Perforation
Esophagectomy
Esophagogastric Junction
Esophagus
Humans
Manometry
Middle Aged
Stents
Weight Loss
Barium
Carcinoma, Squamous Cell
Esophageal Neoplasms