Esophageal carcinoma


  • A 52 years old lady
  • No known medical illness
  • Presented with progressive dysphagia
  • Associated with significant weight loss
Barium swallow

Fluoroscopy (Barium swallow) findings:

  • A & B: frontal and lateral projection of upper esophagus show that the cervical part of esophagus is normal.
  • C: Mid esophagus in frontal projection shows a lobulated intraluminal filling defect seen within the esophagus starting at the level of carina (yellow arrows).
  • D: Mid and distal esophagus in frontal projection shows narrowing with minimal flow of contrast throughout the mid and distal esophagus. The GE junction appears normal.
CT scan thorax in axial planes, post contrast
CT scan reformatted image in sagittal and coronal plane

CT scan findings:

  • Irregular circumferential thickening of the esophageal wall
  • It involves long segment of esophagus at mid and distal portion
  • Associated luminal narrowing noted at the same region (red arrows)
  • The esophagus proximal to this is abnormally dilated (white arrows)
  • Bilateral pleural effusion seen (blue arrows). No lung nodule.

Diagnosis: Esophageal carcinoma (HPE: moderately differentiated SCC)


  • Esophageal cancer is the third most common gastrointestinal malignancy and is among the 10 most prevalent cancers worldwide.
  • More than 90% of esophageal cancers are either squamous cell carcinomas (SCCs) or adenocarcinomas.
  • SCCs are evenly distributed between the middle and lower esophagus, whereas approximately three-fourths of all adenocarcinomas are found in the distal esophagus.
  • Fluoroscopy shows irregular stricture, pre-stricture dilatation with ‘hold up‘ and shouldering of the stricture.
  • CT scan shows eccentric or circumferential wall thickening >5 mm, peri-oesophageal soft tissue and fat stranding. Dilated fluid- and debris-filled oesophageal lumen is seen proximal to an obstructing lesion. Tracheobronchial and aortic invasion can also be seen.
Author: radhianahassan