Cases reported "Esophageal Neoplasms"

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1/2. Healing of malignant ulceration in a case of early oesophageal carcinoma presenting as haematemesis.

    A 77-year-old male was hospitalised following haematemesis of sudden onset. Emergency endoscopy revealed an oesophageal ulcer 5 cms in length. Biopsies taken from the margin of this lesion showed severe dysplastic changes. The patient was seen one month later, at which time his general condition was good, and there was no dysphagia. A second endoscopy showed that the ulcer had healed, and in its place was found a mucous plaque which was redder than normal. This plaque was iodonegative. Biopsies taken from this region confirmed a diagnosis of carcinoma in situ of the oesophagus. To our knowledge this is the first recorded case in which a malignant ulcer has healed.
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keywords = haematemesis
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2/2. Fatal non-malignant ulceration in the gastric tube after oesophagectomy.

    The clinical, histological, and necropsy findings of three cases of fatal, nonmalignant ulceration in the gastric tube after oesophageal resection for oesophageal malignancy are presented. The deaths occurred three, 30, and 42 months, respectively, after initial surgery. Two of the patients had received chemoradiotherapy, one at initial presentation, and one for a recurrence 18 months after surgery. In two patients death was due to an aspiration pneumonia, consequent on the development of a gastrobronchial fistula. The third patient died after a massive haematemesis. In none of the cases was there any evidence of residual or recurrent malignancy at necropsy, although in the two cases where radiological and endoscopic assessment was performed before death, recurrent tumour had been clinically diagnosed. As improved surgical techniques reduce the incidence of death due to anastomotic leakage and combined modality treatment regimens offer improved prospects of tumour remission, deaths from other causes will assume a greater importance. As such, the possibility that ulceration in the gastric tube may be due to causes other than tumour recurrence deserves greater recognition.
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ranking = 0.2
keywords = haematemesis
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