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Malignancy-induced secondary achalasia

H P Parkman1, S Cohen

  • 1Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19140.

Dysphagia
|January 1, 1993
PubMed
Summary

Secondary achalasia, often caused by cancer, presents with dysphagia. Key indicators include short symptom duration, weight loss, and age over 55, prompting further investigation for malignancy.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Radiology

Background:

  • Secondary achalasia develops due to an underlying disorder, frequently malignancy.
  • Adenocarcinoma of the esophagogastric junction is the most common cause of malignancy-induced achalasia.
  • Noncontiguous tumors can also lead to secondary achalasia.

Purpose of the Study:

  • To highlight the importance of recognizing malignancy-induced secondary achalasia.
  • To inform gastroenterologists and radiologists about diagnostic clues.
  • To emphasize prompt diagnosis for effective treatment of the underlying neoplasm.

Main Methods:

  • Review of clinical, radiographic, and manometric findings associated with secondary achalasia.
  • Identification of clinical features suggesting malignancy.
  • Discussion of diagnostic imaging modalities.

Main Results:

  • Malignancy is a recognized cause of secondary achalasia.
  • Three key clinical features suggest malignancy: dysphagia < 1 year, weight loss > 15 pounds, and age > 55 years.
  • Standard diagnostic methods like esophagrams and endoscopy may be insufficient.

Conclusions:

  • Recognizing secondary achalasia is crucial as treatment targets the underlying malignancy.
  • Clinical suspicion is vital when suggestive features are present.
  • Advanced imaging like CT scans and endoscopic ultrasonography is necessary for diagnosis.

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