An unusual case of submucosal invasion of esophageal squamous cell carcinoma mistaken as primary achalasia.
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.
Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jung Ho
JH
Park
Dong Il
DI
Park
Hong Joo
HJ
Kim
Yong Kyun
YK
Cho
Chong Il
CI
Sohn
Woo Kyu
WK
Jeon
Byung Ik
BI
Kim