Carcinoma of the esophagus simulating "downhill" varices

A case of esophageal carcinoma which showed an upper mediastinal mass shadow on plain chest X-ray film and varicoid lesions on esophagogram is reported. The findings seemed compatible with "downhill" varices, an unusual form of esophageal varices caused by superior vena caval obstruction. In this case, contrast-enhanced computed tomography (CE-CT) was useful for the differential diagnosis between varices and varicoid tumor.