What Are the Symptoms of an Esophagus Tumor?

There are many types of benign tumors of the esophagus. Leiomyoma is the most common benign esophageal tumor and can be multiple, but most patients have a good prognosis. The most common esophageal malignancy is squamous cell carcinoma, followed by adenocarcinoma. Other esophageal malignancies include lymphoma, leiomyosarcoma, and metastatic cancer. In the following, esophageal cancer is taken as an example.

Basic Information

English name

tumors of esophagus

Visiting department

Oncology

Common symptoms

Difficulty swallowing, chest pain

Causes of esophageal tumors

As with other tumors, the etiology and pathogenesis of esophageal tumors are unknown.

Clinical manifestations of esophageal tumors

Early esophageal cancer can be asymptomatic. When the esophageal lumen is narrower than 14mm, the most common symptom is difficulty swallowing (difficult to swallow or obstruction when the food moves down the esophagus). The patient first has difficulty swallowing solid food, and then semi-solid food. Difficulty swallowing liquid food and saliva, the progression of these stages suggests a progressive malignant course rather than convulsions, benign or digestive stenosis. Chest pain often radiates to the back.

Even if the patient has a normal appetite, weight loss is almost always present. Compression of the recurrent laryngeal nerve can cause vocal cord paralysis and hoarseness. Compression of sympathetic nerves can produce Horner syndrome, and compression of nerves in other parts can also cause spinal pain, hiccups, and paralysis of the diaphragm. Malignant pleural effusion and lung metastases can cause difficulty breathing. Tumors that develop into the cavity can produce swallowing pain, vomiting, vomiting blood, black stools, iron deficiency anemia, lung aspiration, cough, lung abscess, and pneumonia. Other symptoms include superior vena cava syndrome, malignant ascites, and bone pain.

Because the lymph of the entire esophagus is drained through the lymphatic plexus, lesions of the internal venous lymphatics, cervical lymphatics, supraclavicular lymphatics, diaphragmatic lymphatics, and abdominal lymphatics can occur. Tumors can often metastasize to the lungs and liver, or even distant (such as bone, heart, brain, adrenal gland, kidney, peritoneum).

Esophageal tumor examination

1. Barium X-ray examination

It can be done before the gastroscopy, which shows the condition of the tumor to reduce the risk of perforation or injury caused by careless insertion of the endoscope. Barium X-rays can also show the extent of the tumor's obstruction, and see if coughing and difficulty in inhaling are caused by obstruction or by the backflow of food and saliva into the trachea or tracheoesophageal fistula.

2. Endoscopy

Diagnostic biopsy and cytobrush can be performed, and tumor size and tumor location (relationship with the ring pharynx and palate) can be determined. Endoscopy can also be used to expand the esophagus or place a Stent to maintain the caliber of the esophagus lumen or close the tracheoesophageal fistula.

3.CT

Understanding of lymphadenopathy, distant organ metastasis helps stage and malignant fluid collection (pleural effusion and ascites), and helps to determine the possibility of surgery, location of radiotherapy and prognosis. The cost of magnetic resonance is more than that of CT, and there is no special advantage. The application is limited due to the lack of good oral contrast agents.

4. Endoscopic ultrasound

It is a newer technology that can measure the extent of tumor expansion in the wall (esophageal wall) and the involvement of nearby lymph nodes in detail.

Esophageal tumor diagnosis

Although barium X-ray examination can confirm the diagnosis of esophageal obstructive disease, gastroscopy plus biopsy and cytology are better diagnostic methods. Although the positive rate of biopsy can reach 70%, the positive rate of cell brush test is more than 95%. The most common tumors are epithelial cell carcinomas, and those tumors outside the esophagogastric junction are 30% to 40% adenocarcinomas.

Esophageal Cancer Treatment

Surgical treatment

The treatment of esophageal cancer can be surgical resection. The choice of surgery depends on the location and size of the tumor, the surgeon's experience and the purpose of the operation.

2. chemotherapy

Where appropriate, surgery can provide patients with the longest remission period, and chemotherapy can extend the survival of some patients.

3. Radiotherapy

Extracorporeal beam radiation therapy (radiotherapy) is usually used as the primary treatment for patients without radical surgery, including those in advanced stages.

4. Other palliative surgery

Other palliative measures include dilatation, ductal repair (Stent fixation membrane), and laser coagulation of lumen tumors.