Laryngeal carcinoma and a lower esophageal web. (Esophagoscopy Clinic).A 57-year-old man came to us with a chief complaint of dysphonia dysphonia /dys·pho·nia/ (-fo´ne-ah) a voice impairment or speech disorder.dysphon´ic dys·pho·ni·a n. Difficulty in speaking, usually evidenced by hoarseness. and a 5-year history of heartburn. He had also recently begun experiencing dysphagia for solids. He denied tobacco and alcohol use. Transnasal fiberoptic laryngoscopy revealed the presence of a lesion on the posterior aspect of his right true vocal fold (figure, A). Transnasal esophagoscopy (TNE) detected a lower esophageal web located 6.5 cm above the lower esophageal sphincter lower esophageal sphincter n. A ring of smooth muscle fibers at the junction of the esophagus and stomach. Also called cardiac sphincter. (LES) (figure, B). In addition, metaplastic metaplastic characteristic of metaplasia. gastric epithelium could be seen extending above the LES up to the web. Analysis of endoscopic biopsies of the laryngeal lesion performed through the TNE scope yielded a diagnosis of squamous cell carcinoma squamous cell carcinoma n. A carcinoma that arises from squamous epithelium and is the most common form of skin cancer. Also called cancroid, epidermoid carcinoma. . Biopsies taken above the LES and below the web confirmed the diagnosis of Barrett's metaplasia metaplasia /meta·pla·sia/ (met?ah-pla´zhah) the change in the type of adult cells in a tissue to a form abnormal for that tissue. . The patient underwent endoscopic resection (microflap) of the vocal fold carcinoma and was scheduled to undergo a repeat endoscopy in 2 years for surveillance of Barrett's metaplasia. |
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