A 72-year-old man, with a history of ex-smoker (for 17 years), moderate drinker and COPD under treatment; referred from the Digestive Service for a study of dysphagia to solids and liquids with anorexia and progressive weight loss.
An oral endoscopic study was performed, reporting the existence of a mameloned and stenosing mass from 32 cm to the oesophagogastric junction, in which a fistulous orifice was observed, the trajectory and distal end being unknown; in the biopsy only the moderately differentiated, ulcerated and infiltrating epidermoid component of the neoplasm was found. The thoraco-abdominal CT scan showed thickening of the oesophageal wall in the lower third and oesophageal-gastric junction, in the caudal portion of which there was a small filiform lumen, without identifying the fistulous tract described; no mediastinal or abdominal organ involvement. The barium oesophagogastroduodenal study revealed a stenosis of 1-5 cm in length in the lower third of the oesophagus, with no other relevant findings. Echoendoscopy showed a lesion affecting all the layers of the oesophageal wall, starting immediately at the subcarinal level, extending towards the left edge where some points exceeded the adventitia, penetrating minimally into the periesophageal fat, contacting the aorta and right pleura, without invading it; from the lymph node point of view, only a small subcarinal lymphadenopathy with an inflammatory appearance was observed (T3N0).

Oesophagectomy, intrathoracic gastroplasty and feeding jejunostomy were performed.
The anatomopathological study of the surgical specimen showed a 5 cm infiltrating cancer with a well-differentiated epidermoid and microcytic component, with 2 isolated adenopathies with a clear predominance of the microcytic component and involvement of the circumferential border.
He subsequently underwent adjuvant chemotherapy (carboplatin, etoposide) and radiotherapy (60 Gy). Ten months after diagnosis, the CT scan was repeated and showed images compatible with liver metastases, which led to the initiation of palliative chemotherapy with etoposide, which he continues to receive today.

