Summary
A 69-year-old white man developed progressive symptoms of dysphagia for solids and liquids and regurgitation of undigested food accompanied by a 12-kg weight loss over a 4-month period. Initially, radiographs of the esophagus and stomach were normal, but when repeated 4 months later, a diagnosis of achalasia was suggested. Esophageal manometry performed at the time demonstrated a motor abnormality of the esophagus and lower esophageal sphincter consistent with a diagnosis of achalasia. Upper endoscopy revealed a small ulcerated tumor in the cardia of the stomach. A biopsy specimen was interpreted as adenocarcinoma of the stomach. Surgical treatment included resection of the gastric tumor along with a 4-cm segment of the distal esophagus, resection of a collar of apparently uninvolved stomach, and esophagogastrostomy. Nine months following surgery the patient was restudied. An upper gastrointestinal roentgenogram demonstrated a return of esophageal caliber and configuration to normal. Manometry showed that esophageal contractions had reverted to a normal progressive, postdeglutition pattern throughout the length of the esophagus. This is the first report in which achalasia secondary to gastric adenocarcinoma was reversed after tumor resection.
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References
Asherson N: Cardiospasm: Intermittent: An initial manifestation of carcinoma of the cardia. Br J Tuberc 47:39–40, 1958
Kolodny M, Schrader ZR, Rubin W: Esophageal achalasia probably due to gastric carcinoma. Ann Intern Med 69:569–572, 1968
Bessent CT, Lopex CA, Cocco AE: Carcinoma of the esophagogastric junction mimicking achalasia. Md State Med J 22:47–50, 1973
Shulze KS, Goresky CA, Jabbari M: Esophageal achalasia associated with gastric carcinoma: Lack of evidence for widespread plexus destruction. Can Med Assoc J 112:857–864, 1975
Tucker HJ, Snape WJ, Cohen S: Achalasia secondary to carcinoma: Manometric and clinical features. Ann Intern Med 89:315–318, 1978
Serebro HA, Prentice RSA, Venkatachalam B: Possible pathogenesis of motility changes in diffuse spasm associated with gastric carcinoma. Can Med Assoc J 102:1257–1259, 1970
Davis JA, Kantrowitz PA, Chandler HL: Reversable achalasia due to reticulum cell sarcoma. N Engl J Med 293:130–132, 1975
Mellow MH: Return of esophageal peristalsis in idiopathic achalasia. Gastroenterology 70:1148–1151, 1976
Olsen AM, Schlegel JF, Creamer B: Esophageal motility in achalasia (cardiospasm) after treatment. J Thorac Surg 34:615–623, 1957
Vantrappen G, VanGoidsenhoven GE, Verbeke S: Manometric studies in achalasia of the cardia, before and after pneumatic dilatations. Gastroenterology 45:317–325, 1963
Kurlander DJ, Raskin HF, Kirsner JB: Therapeutic value of the pneumatic dilator in achalasia of the esophagus. Gastroenterology 45:604–613, 1963
Seaman WB, Wells J, Flood CA: Diagnostic problems of esophageal cancer. Relationship to achalasia and hiatus hernia. J Roentgenol Radium Nucl Med 90:778–791, 1963
Herrera AF, Colon J, Valdes-Dapena A: Achalasia or carcinoma? The significance of the mecholyl test. Am J Dig. Dis. 14:1073–1081, 1970
Larrain A, Csendes A, Pope CE: Surgical correction of reflux. An effective therapy for strictures. Gastroenterology 69:578–583, 1975
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Menin, R., Fisher, R.S. Return of esophageal peristalsis in achalasia secondary to gastric cancer. Digest Dis Sci 26, 1038–1044 (1981). https://doi.org/10.1007/BF01314770
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DOI: https://doi.org/10.1007/BF01314770