Early detection of gastric cancer with esophageal extension by transnasal esophagoscopy.An 82-year-old man presented to the office complaining of one episode of pill dysphagia and intermittent episodes of a feeling that food was sticking low in his chest. Flexible laryngoscopy revealed posterior glottic glot·tic adj. 1. Of or relating to the tongue. 2. Of or relating to the glottis. glottic pertaining to (1) the glottis, or (2) the tongue. erythema erythema (ĕr'əthē`mə), more or less diffuse redness of the skin due to concentration of an abnormally large amount of blood within the small vessels of the skin (hyperemia), as in burns. and edema edema (ĭdē`mə), abnormal accumulation of fluid in the body tissues or in the body cavities causing swelling or distention of the affected parts. and bilateral pseudosulcus vocalis consistent with laryngopharyngeal reflux. Because of the patient's pill dysphagia, transnasal esophagoscopy (TNE TNE The Net Effect (UK) TNE Trusted Network Environment TNE The New Economics TNE Trans-Nasal Esophagoscopy TNE Test Nacelle Equipment TNE Thermal Noise Effect TNE Tina Network Element ) was performed. A fungating mass near the gastroesophageal gastroesophageal /gas·tro·esoph·a·ge·al/ (-e-sof?ah-je´al) 1. pertaining to the stomach and esophagus. 2. proceeding from the stomach to the esophagus. junction was detected (figure, A). Analysis of multiple biopsies revealed that the mass was an adenocarcinoma. A secondary mass within the stomach was also noted (figure, B). [FIGURES OMITTED] Gastroenterology evaluation included an MRI 1. (application) MRI - Magnetic Resonance Imaging. 2. MRI - Measurement Requirements and Interface. of the chest and abdomen and endoscopic ultrasound, which revealed local extension and invasion of the pancreas by the tumor. The patient is currently being evaluated for palliative chemotherapy and radiation. This case is an example of how the ready availability of TNE resulted in much earlier diagnosis of gastric carcinoma with esophageal extension than would otherwise be expected. Although the aggressive local extension of this particular tumor precluded surgical cure, early cancer detection generally improves survival. Timothy D. Anderson, MD; Steven F. Nezhad, MD From the Department of Otolaryngology (Dr. Anderson) and the Department of Gastroenterology (Dr. Nezhad), The Lahey Clinic, Burlington, Mass. |
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