Esophageal cancer

Question 1

Adenocarcinoma

SCC

Rf
Demo
M:F
Location
Appearance

Esophageal cancers

Answer 1

A- GERD, hiatal hernia, obesity
Caucasian
M>>F
distal 1/3
Flat, ulcerated

SCC- Smoking, alcohol, nitrates/salt
AA, Low SES
M>F
Proximal 2/3
Fungating

Question 2

Patho of esophageal adenocarcinoma

Answer 2

Barrets esophagus- glands resemble intestinal glands at GE jxn, advance proximally

Dysplasia- cells appear, dont penetrate BM

Invasive- form ulcerated mass

Question 3

Esophageal cancer progression

Answer 3

Spread by direct extension through esophageal wall, adhere to organs

Lymph spread via para-aortic LN

Hematogenous, usually to Lung/bone

Question 4

CM of esophageal cancer

Answer 4

Dysphagia (s, then l)
weight loss (dysphagia, tumor anorexia, dietary changes)
odynophagia, CP, aspiration PNA
Fe defic anemia

Question 5

Test of choice for esophageal cancer

SCC presentation
Adeno presentation

Answer 5

Upper endoscopy

SCC- squamous epithelium, keratinization as they invade mucosa

Adeno- atypical glands, irregular appearance

Question 6

Screening indicated for

Risk factors

Answer 6

BE/dysphagia in men over 50

Caucasin, obesity, smoking, FH

Question 7

Tx esophageal cancer

Answer 7

Resection of tumor/LN
Esophagectomy

Usually alongside chemo w/wo radiation therapy