Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. The esophagus is a muscular tube that moves food and liquids from the throat to the stomach.
The most common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma begins in flat cells lining the esophagus. Adenocarcinoma begins in cells that make and release mucus and other fluids.
Smoking and heavy alcohol use increase the risk of esophageal squamous cell carcinoma. Gastroesophageal reflux disease and Barrett esophagus may increase the risk of esophageal adenocarcinoma.
Esophageal cancer is often diagnosed at an advanced stage because there are no early signs or symptoms.
Presenting signs and symptoms of esophageal cancer include the following:
Dysphagia (most common); initially for solids, eventually progressing to include liquids
Weight loss (second most common)
Epigastric or retrosternal pain
Bone pain with metastatic disease
Imaging studies used for diagnosis and staging include the following:
Esophagogastroduodenoscopy (allows direct visualization and biopsies of the tumor)
Endoscopic ultrasonography (EUS; most sensitive test for T and N staging)
Computed tomography of the abdomen and chest (for assessing lung and liver metastasis and invasion of adjacent structures)
Positron emission tomography (PET) scanning (for staging)
Bronchoscopy (to help exclude invasion of the trachea or bronchi)
Laparoscopy and thoracoscopy (for staging regional nodes)
Barium swallow (very sensitive for detecting strictures and intraluminal masses, but now rarely used)
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