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Recurrent gastric carcinoma causing pseudoachalasia: case report.
C Iascone1, C Maffi, C Pascazio
11st Department of Surgery, Pietro Valdoni, Università La Sapienza, Policlinico Umberto I, Rome, Italy.
Summary
Gastric remnant cancer recurrence mimicked achalasia, delaying diagnosis. Advanced imaging eventually revealed the unresectable tumor, leading to palliative surgery.
Area of Science:
- Gastroenterology
- Oncology
- Radiology
Background:
- Gastric remnant cancer recurrence can present insidiously.
- Secondary achalasia (pseudoachalasia) is a rare but serious complication of gastric malignancy.
Observation:
- A patient with a history of resected antral carcinoma developed symptoms of dysphagia and weight loss.
- Initial investigations including barium swallow, endoscopy, and CT scan were inconclusive for recurrence.
Findings:
- Despite negative initial workup, progressive symptoms prompted further investigation.
- A subsequent CT scan revealed gastric wall thickening and cardia involvement, indicative of tumor recurrence.
- Exploratory laparotomy confirmed an unresectable tumor invading the diaphragm and mediastinum.
Implications:
- This case highlights the importance of considering malignancy in pseudoachalasia, even with initially negative diagnostic tests.
- Advanced imaging techniques are crucial for detecting subtle recurrences.
- Timely diagnosis and palliative care are essential for managing advanced gastric remnant cancer.
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