title: Right-angled narrowing of the distal oesophagus secondary to carcinoma of the tail of the pancreas.
abstract: Dysphagia due to secondary involvement of the oesophagus by pancreatic carcinoma is relatively rare. Occasionally, the oesophagus may be involved by direct extension of a carcinoma of the body and/or tail of the pancreas or metastatic lymphadenopathy in the posterior mediastinum. Although the literature contains a few case reports in which barium studies revealed displacement or obstruction of the distal oesophagus, a benign-appearing, smooth, tapered narrowing of the distal oesophagus with a fixed, right-angled configuration is a radiological finding which has not been previously emphasised. In the author's experience, this abnormality may be a helpful radiological clue to the diagnosis of carcinoma of the tail of the pancreas. The clinical, radiological and pathological findings in four patients with dysphagia and a right-angled narrowing of the distal oesophagus secondary to carcinoma of the tail of the pancreas are described and illustrated; the radiological differential diagnosis is briefly discussed.
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D011859:Radiography