case_images: PMC10663043_01
case_images: Axial planes from same CT scan at upper thoracic esophagus level (a) and lower thoracic esophagus level (b) show miliary involvement of the esophageal serosa with diffuse and regular thickening of all layers of the wall of the thoracic and abdominal esophagus. It is associated with enlarged mediastinal lymph nodes (a, arrowhead), a slight amount of periesophageal fluid (b, arrowhead), and a right pleural effusion (b, arrow).
case_images: cro-2023-0016-0001-534702_F01.jpg
case_images: PMC10663043_01_cro-2023-0016-0001-534702_F01.jpg
case_images: F1
case_images: In December 2022, clinical symptoms progressed to dysphagia and aphonia, and the Ca 125 levels increased dramatically from 300 UI/mL to 1,500 UI/mL in 2 weeks, and a CT scan showed esophageal thickening, shown in Figure 1.
case_images: Endoscopic picture shows deep excavated ulcerations with whitish exudate suggestive of infiltrative etiology associated with candidiasis throughout the esophagus lumen. Perforation to the mediastinum (blue arrow). Normal stomach and duodenum.
case_images: cro-2023-0016-0001-534702_F02.jpg
case_images: PMC10663043_01_cro-2023-0016-0001-534702_F02.jpg
case_images: F2
case_images: We considered to repeat esophagogastroscopy, which revealed a fibrinated ulcer measuring 15 mm with an ovoid morphology compatible with fistulation to the mediastinum, as shown in Figure 2.
case_images: Fragments of squamous mucosa infiltrated by atypically marked neoplastic cells expressing PAX8 and WT1.
case_images: cro-2023-0016-0001-534702_F03.jpg
case_images: PMC10663043_01_cro-2023-0016-0001-534702_F03.jpg
case_images: F3
case_images: Pathological reports have described infiltration by high-grade serous carcinoma consistent with disease progression, as shown in Figure 3.