title: Esophageal stenosis: a differential diagnosis between esophageal cancer and metastasis from other neoplasia.
abstract: BACKGROUND
  The occurrence of radiological mediastinal lymphadenopathy as the only evidence of tumor recurrence of cervical carcinoma is very rare. We report on such a case with stenosis of the esophagus.
  
  
  METHODS
  A 36-year-old Caucasian woman, without any relevant history of gynecological cancer, underwent a trans-vaginal ultrasound with evidence of any cervical lesion locally extended. After histologically-proven diagnosis of squamous cell carcinoma of the cervix uterine, the patient was treated by neoadjuvant chemoradiation, followed by total abdominal hysterectomy with bilateral salpingoophorectomy. A subsequent close follow-up was negative for recurrence of disease until December 2008, two years after diagnosis. At that period, the patient experienced cough and severe dysphagia and for this reason she underwent several examinations including esophagogastroduodenoscopy, whole-body computed tomographic scan and bronchoscopy with transbronchial needle aspiration. Histology led to diagnosis of recurrence of cervical cancer, HPV31-positive, in multiple mediastinal lymphnodes, with infiltration of the esophageal mucosa.
  
  
  CONCLUSIONS
  Mediastinal lymphade-nopathy in patients with a history of cervical carcinoma should be suspicious of metastatic disease, even if there is no radiological evidence of distant metastases.
authors.affiliation: Department of Medical Oncology, Ospedale S. Andrea, via di Grottarossa n°1035-1039, 00189, Rome, Italy. elisaonesti@gmail.com.
authors.forename: Ida
authors.initials: I
authors.lastname: Paris
authors.forename: Arsela
authors.initials: A
authors.lastname: Prelaj
authors.forename: Concetta Elisa
authors.initials: CE
authors.lastname: Onesti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Baldoni
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Giovagnoli
authors.forename: Maria
authors.initials: M
authors.lastname: Bassanelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lauro
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D004940:Esophageal Stenosis / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D011379:Prognosis
keywords: Esophageal stenosis; cervical cancer; mediastinal lymph node; recurrence of cervical carcinoma