A 72-year-old male presented with a history of ex-smoker (since 17 years of age), binge drinker and COPD under progressive weight loss due to dysphagia study to solids and anorexia.
An oral endoscopy was performed to report the existence of a mamelon mass and this mass was found in only the squamous cell carcinoma located at 32 cm. The distal orifice was moderately differentiated and the ulcerated tract was unknown.
Caudal-abdominal TAC shows a thickening of the esophageal wall in the lower third and gastric oesophagus junction, in which there is a small intestinal lumen, without identifying the fistula tract.
Choledochogastroduodenal barium study revealed stenosis of 1-5 cm in length in the lower third of the esophagus, with no other relevant findings.
Echoendoscopy shows a lesion that affects all layers of the esophageal wall that begins immediately at the subcarinal level, extending to the left border where some point surpasses the adventitia, contacting only a small periophtallic aspect of fatty
1.
The patient underwent surgery, intrathoracic surgery and gastrostomy feeding.
The pathological study of the surgical specimen showed a cancer border 5 cm with well differentiated and microcytic epidermoid component, with 2 isolated adenopathies with clear predominance of the microcytic component and circumferential involvement.
He was subsequently submitted to adjuvant chemotherapy (carboplatin, etomidate) and radiotherapy (60 Gy).
Ten months after the diagnosis, a CT scan was repeated, which showed images compatible with liver metastases. The patient continued to receive chemotherapy with atypical chemotherapy.
