1/110. Dysphagia secondary to invasive candidiasis of a jejunal free flap.The presence of a mass in a jejunal free flap that causes dysphagia less than two years after a pharyngolaryngectomy for carcinoma usually indicates tumour recurrence. We present a case of invasive candidiasis of a jejunal free flap presenting with dysphagia and a mass. To our knowledge this is previously unreported. Such a cause should always be considered in the differential diagnosis, as early recognition and treatment are likely to result in a favourable outcome.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/110. radiation-induced esophageal carcinoma 30 years after mediastinal irradiation: case report and review of the literature.A 54-year-old man who had been irradiated in 1964 for cervical involvement by Hodgkin's disease was admitted in December 1994 to our clinic with strong complaints of dysphagia. The reason was a moderately differentiated squamous cell carcinoma of the proximal esophagus in the previously irradiated region. The patient had no risk factors (abuse of nicotine or alcohol) for the developement of esophageal carcinoma. A reirradiation was performed, but the disease progressed locally and two weeks after the beginning of the therapy the patient developed two tracheoesophagocutaneous fistulae. The radiation therapy was discontinued and the tumor stenosis was bridged by a tube closing the fistulae. A retrospective dose analysis to evaluate the applied doses will be performed. Furthermore, an overview of 66 cases of the literature with radiation-induced esophageal carcinoma analysed concerning applied dose and latent interval will be given. In conclusion the reported case fits the criteria for radiation-induced malignancies (Chudecki Br J Radiol 1972;45:303-4) known from literature: (1) a history of previous irradiation, (2) a cancer occurring within the irradiated area, (3) gross tissue damage due to an excessive dose of radiation, and (4) a long latent interval between irradiation and development of cancer. Esophageal carcinomas belong to the rare secondary malignancies after the therapeutic use of ionizing radiation. Nevertheless in patients with dysphagia they should be suspected as a differential diagnosis even many years after mediastinal irradiation. The treatment of these tumors is very difficult and is associated with a poor prognosis.- - - - - - - - - - ranking = 8keywords = carcinoma (Clic here for more details about this article) |
3/110. Dysphagia: caveat oesophagum.The seriousness of dysphagia as a symptom is emphasised. Two illustrative cases are described in which carcinoma of the oesophagus causing dysphagia was diagnosed late. The importance of early barium studies and early oesophagoscopy is stressed. The poor results of management of carcinoma of the oesophagus associated with late diagnosis are illustrated in the patient data presented.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
4/110. In-continuity fundic bypass for palliation in unresectable carcinoma of the oesophagus: a previously unreported procedure.Surgical bypass for the palliation of dysphagia in patients with unresectable oesophageal carcinoma continues to be an option in developing countries, as the cost of a good quality endo-prosthesis is well beyond the means of most patients. One such case is presented in which an in-continuity fundic bypass (without resection of the lesser curvature and cardia, thereby not disconnecting the oesophago-gastric junction) was made with gratifying results with regard to quality of life. awareness of this previously unreported procedure is important because it adds to the armamentarium of surgeons wanting to provide palliation for dysphagia and aspiration in patients with unresectable carcinoma of the oesophagus.- - - - - - - - - - ranking = 6keywords = carcinoma (Clic here for more details about this article) |
5/110. Unusually aggressive rectal carcinoid metastasizing to larynx, pancreas, adrenal glands, and brain.Rectal carcinoids are slow-growing tumors. They metastasize when their size is more than 2 cm. Common sites of metastasis are the liver, lungs, and bones. Metastases to thyroid, pancreas, kidneys, adrenal glands, pituitary glands, posterior fossa, and spleen are very rare. We present the case of a 79-year-old white man with dysphagia and left vocal cord paralysis from a rapidly growing mass in his neck. Needle biopsy suggested thyroid anaplastic carcinoma, and the patient underwent total laryngectomy, total thyroidectomy, and left radical neck dissection. pathology showed undifferentiated carcinoid of the larynx. biopsy of a rectal mass suggested poorly differentiated carcinoma. Postoperatively the patient developed cardiac arrhythmias and died after 5 weeks. autopsy showed a 5-cm carcinoid of the rectum with extensive vascular invasion extending into the perirectal fat. There was metastatic disease to both lungs, liver, pancreas, both adrenal glands, peritoneum, subcutaneous tissues of thorax and abdomen, ribs, vertebrae, skull, and the leptomeninges of the cerebrum. Rectal carcinoids may present a variable histologic picture. Poorly differentiated tumors can present with widespread metastases and have poor prognosis. Extensive surgery may not improve the survival of patients with this pattern of unusually aggressive carcinoid.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
6/110. Esophageal hypermotility associated with intramural pseudodiverticulosis. Primary esophageal disease or epiphenomena?Esophageal intramural pseudodiverticulosis is a very rare disease of unclear etiology. The clinical picture is characterized by progressive dysphagia. Because of its frequent association with alcohol abuse and subsequent weight loss, it must be differentiated reliably from esophageal carcinoma. The diagnosis is established by the characteristic detection of multiple intramural contrast accumulations in the barium esophagogram. Additional endoscopic and endosonographic confirmation and histological examination are required to exclude a malignant tumor. Moreover, associated diseases are almost always present and should also be diagnosed by pH-metry, cytology, and esophageal manometry. Good and long-lasting therapeutic success can be achieved by bouginage of the stenosis with concomitant treatment of the associated esophageal diseases. Based on two case reports of patients with this disease, we discuss the unusual association with esophageal hypermotility as well as the symptoms, clinical course, therapy, and pathogenesis of the disease.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
7/110. actinomycosis of the post-cricoid space: an unusual cause of dysphagia.Cervicofacial actinomycosis is known to affect many soft tissues and bony structures in the head and neck. However to the authors' knowledge, actinomycosis of the post-cricoid region has not been previously reported. A case of a 74-year-old male who developed actinomycosis of the post-cricoid region after radiotherapy for a laryngeal carcinoma is presented. actinomycosis should be considered in the differential diagnosis of dysphagia following radiotherapy for squamous cell carcinoma of the larynx, as early treatment is likely to result in a favourable outcome.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
8/110. A concomitant occurrence of esophageal and cervical carcinoma in a sixty year old female patient from Bale Zone of Oromia Regional State, a case report with literature review.Oesophageal carcinoma usually presents with difficulty of swallowing initially for solid food materials later even for liquid diets. Cervical carcinoma presents with pain and bleeding per vaginum during intercourse (sexual contact). We report a concomitant occurrence of squamous cell carcinoma of esophagus and cervix in a 60 years old female patient from Bale Zone of Oromia Regional State, who initially presented with vaginal bleeding of 2 years duration and later with difficulty of swallowing of 9 months duration. To our knowledge this is the first report of a concomitant occurrence of esophageal and cervical carcinoma in ethiopia.- - - - - - - - - - ranking = 8keywords = carcinoma (Clic here for more details about this article) |
9/110. The causes of dysphagia in carcinoma of the lung.Dysphagia occurs in only a small percentage of patients with lung cancer, but the frequency of this cancer means that large numbers are affected. Non-quantitative analysis of a large Scottish series of lung cancer cases indicates the following eight broad categories of dysphagia according to underlying mechanisms: mediastinal disease; cervical lymphadenopathy; brainstem lesions; gastrointestinal tract metastases; associated systemic disorders; second primaries; oropharyngeal and oesophageal infections; and radiation-induced oesophageal toxicity.- - - - - - - - - - ranking = 4keywords = carcinoma (Clic here for more details about this article) |
10/110. Barrett's esophagus and achalasia.Two unusual cases of achalasia with endoscopic and histologic documentation of Barrett's esophagus are presented. One patient had Barrett's esophagus at the time of initial endoscopy for achalasia, before any treatment. The other patient developed specialized columnar epithelia in the esophagus after treatment with pneumatic dilation. Each patient had evidence of low-grade dysplasia. Including these two patients, 30 cases of Barrett's esophagus in patients with achalasia have been reported in the literature. In 73% (22 of 30) of the cases, Barrett's esophagus was detected after esophagomyotomy. In 20% (6 of 30) of the cases of achalasia and Barrett's esophagus, adenocarcinoma developed. The current two cases are unusual because Barrett's esophagus in achalasia generally develops from gastroesophageal reflux after esophagomyotomy. No other patients have been reported to develop Barrett's esophagus after pneumatic dilation alone. patients with achalasia and Barrett's esophagus may be at a particularly high risk for developing dysplasia and adenocarcinoma.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
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