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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Progressive dysphagia is common in patients with advanced esophageal carcinoma. Multiple nonsurgical techniques are available to provide palliation and improved nutrition. Simple dilatation is the oldest technique and newer methods may offer greater efficacy. Laser therapy now provides an excellent opportunity to treat obstructing tumors. Placement of an esophageal prosthesis may become particularly useful when dilatation must be performed too frequently or has become ineffective or in the patient with an esophageal-pulmonary fistula. Newer techniques including BICAP tumor probe, intracavitary radiotherapy, or absolute alcohol injection offer promise. This review discusses the advantages and disadvantages of these different palliative techniques for patients with the extremely poor prognosis associated with esophageal cancer.
Dysphagia 1990
PMID:Palliation of malignant esophageal obstruction. 170 65

In a group of 245 cases of primary carcinoma of the esophagus the authors found three cases of adenoid cystic carcinoma (ACC). Clinical and pathologic data of those patients (one female and two male; age range, 49-74 years) were analyzed. Tumors were localized in the middle third of the esophagus. One patient lived 15 months after surgery. Another is a case of early ACC who has been living 4.5 years after surgery and is without specific symptoms. The third patient had not had surgery and died 13 months after the onset of dysphagia. An autopsy showed only a locally invasive tumor growing into the surroundings of the esophagus, and regional lymph node metastases without distant parenchymal metastases. These findings support pathologic and biologic similarities between ACC of the esophagus and ACC of the salivary glands. There are synchronous tumors of the esophagus and the vital localization which makes the prognosis of ACC of the esophagus worse than ACC of the salivary glands.
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PMID:Adenoid cystic carcinoma of the esophagus. A clinicopathologic study of three cases. 170 15

Palliative surgery, including cleaning resection, colon or stomach bypass, intubation or fistula is all one can offer to the majority of patients suffering from oesophageal carcinoma due to an usually advanced tumor stage at the time of diagnosis. The primary goal is to prevent or resolve dysphagia. A prolongation of survival time can - with the exception of cleaning resection - not be expected by these procedures. The average survival time was 9.4 months after cleaning resection and 4.7 months after other palliative procedures in our series. If a cleaning resection is not possible, the endoscopic implantation of an endotube is the treatment of choice because of its low mortality and morbidity.
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PMID:[Palliative surgical treatment of cancer of the esophagus]. 170 85

Nine patients with advanced squamous cell carcinoma of the middle third of the esophagus were treated by high dose rate intracavitary therapy. The dose delivered was 12 Gy in two sessions at 1 cm from the center of the source. All nine patients were alive after 9 months. Six months after treatment, 4 patients had strictures which were dilated. At the end of nine months, 6 patients had dysphagia, four of whom had strictures and two had recurrence which was treated by further intracavitary irradiation. Intracavitary radiation using high dose rate, remote controlled afterloader has a significant role in palliation in patients with advanced esophageal carcinoma and avoids intubation.
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PMID:High dose rate intracavitary therapy in advanced carcinoma esophagus. 171 Feb 2

Computed tomographic examinations were performed on 24 patients with entirely submucosal laryngeal mass lesions. Presenting complaints were hoarseness (17 patients), dysphagia (1 patient), airway obstruction (5 patients), and a cervical nodal metastasis (1 patient). The masses were visible endoscopically as submucosal bulges in 21 patients. Three other patients presenting with hoarseness and vocal cord paresis or paralysis had otherwise negative endoscopy and a mass demonstrated on CT. Thirteen patients were eventually diagnosed as having squamous cell carcinoma, which was the primary working diagnosis following CT in 12 cases. The group of 13 carcinoma patients had a range of two to five endoscopic procedures with one to four negative biopsies and a 6 week to 9 month delay in histologic confirmation of cancer. Other lesions included five laryngoceles, two chondrosarcomas, and one case each of paraganglioma, fibrosarcoma, lymphoma, and tuberculous laryngitis. Computed tomography is an indispensable tool for evaluating submucosal laryngeal masses or otherwise unexplainable symptoms (usually hoarseness) that might herald such a mass. A definite submucosal mass on CT should prompt a deep or wedge biopsy to reach a pathologic diagnosis. This will avoid the delay in diagnosis that frequently occurs in these patients.
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PMID:CT of submucosal and occult laryngeal masses. 172 14

52 patients with laryngeal carcinoma were studied before and after laryngectomy with regard to what factors might influence the development of oesophageal speech. The investigations consisted of oesophageal manometry, a follow-up interview and a review of surgical approaches and radiotherapy. 43% of the patients achieved socially acceptable oesophageal speech, 22% were able to speak single words, and 35% had no oesophageal speech at all. 61% had post-operative dysphagia. Age was the only factor which significantly correlated to intelligible speech. The intraoesophageal pressure during oesophageal phonation exceeded in all cases the low PO-HPZ pressure after operation. The extension of surgery and radiation field, severity of dysphagia, alcohol and smoking habits, and mental condition did not differ between the 3 groups of oesophageal speech. It was concluded that the rather complicated process of acquiring oesophageal speech is much more dependent on learning ability which decreases with age than on various kinds of motor dysfunction after laryngectomy.
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PMID:Oesophageal speech after laryngectomy: a study of possible influencing factors. 174 90

A case is reported of a 56-year-old woman of Libyan origin presenting with dysphagia, retrosternal pain and weight loss. Oesophago-gastroduodenoscopy revealed an ulcerated tumor in the upper oesophagus strongly suggesting a malignancy. A positive Mendel-Mantoux test along with histological evidence of epitheloid cell granulomas and clinical findings consistent with pulmonary and lymph node tuberculosis led to the presumptive diagnosis of oesophageal tuberculosis. The diagnosis was later confirmed by positive bacteriological cultures of oesophageal biopsies and gastric washings. It is very unusual for dysphagia to be the presenting symptom of active adult tuberculosis. Oesophageal tuberculosis is extremely rare and must be distinguished predominantly from oesophageal carcinoma.
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PMID:An unusual case of active tuberculosis of the oesophagus in an adult. 174 35

Anaplastic thyroid carcinoma, in contrast to well-differentiated thyroid carcinoma, has a dismal prognosis, and little progress has been made in improving survival for this disease. We reviewed our experience during a 23-year period to identify risk factors and possible methods to improve outcome. Between 1966 and 1989, 340 patients with thyroid carcinoma underwent operation. Of these, 17 (5%) were undergoing operative treatment of anaplastic or undifferentiated thyroid carcinoma. The female/male ratio was 3.5:1, and mean age at presentation was 63 years. The most common presenting symptoms included neck mass, voice change, or dysphagia. Unusual presentations included symptomatic bradycardia from compression of the vagus nerve and superior vena cava syndrome. Four patients had a history of well-differentiated thyroid carcinoma. Nine patients had been diagnosed or treated in the past for "goiter" or a neck mass, and four patients had concurrent differentiated thyroid carcinoma associated with the anaplastic tumor. Thus 13 (76%) of 17 patients had a previous thyroid disorder, benign or differentiated malignant, and eight (47%) of 17 patients had previous or concurrent differentiated thyroid carcinoma. At the time of presentation, six patients had unilateral true vocal cord paralysis. At operation, 14 patients had local extension of the tumor and four required tracheostomy. Only five of 12 patients showed response to postoperative radiation therapy. Overall median survival was 12 months, and 13 (76%) of 17 patients died. The two patients alive longer than 12 months had only small foci of anaplastic carcinoma in association with well-differentiated carcinoma. Anaplastic thyroid carcinoma is a locally and systemically aggressive disease, with long-term survival seen only in those with well-localized anaplastic tumor. The major risk factor in this series is a history of previous benign or malignant thyroid disease. Because of this, a more aggressive approach to thyroid masses may be warranted. Long-standing goiters or benign nodules should be followed carefully and considered for resection if they grow or do not respond to medical therapy, and total thyroidectomy for malignant disease may obviate the subsequent development of anaplastic carcinoma. This method of early diagnosis and resection of abnormal thyroid tissue seems to be the only method currently available to improve the nearly uniform fatality of this disease.
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PMID:Anaplastic thyroid carcinoma: risk factors and outcome. 174 83

A case of primary small cell carcinoma of the esophagus is presented. The clinical, radiologic, and pathologic findings of our case and 72 other cases were reviewed. The most common presenting symptoms were weight loss and dysphagia. Eighty percent were larger than 4 cm at presentation and 97% were in the mid to distal esophagus. The esophageal tumors were identical histologically to small cell carcinoma of the lung. Esophageal luminal widening on esophagram has been found to be more common in nonsquamous cell carcinomas. While rare, small cell carcinoma should be considered in the differential diagnosis of primary esophageal tumors, particularly in the presence of these findings.
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PMID:Primary small cell carcinoma of the esophagus: case presentation and review of the literature. 184 35

Synchronous double carcinoma of the lung and the esophagus is extremely rare disease. In Japan, 13 cases have reported by Abo and only 10 clinical cases have been documented so far. We describe two cases of synchronous double carcinoma of the lung and the esophagus. Case 1. A 74-year-old man was admitted to our hospital because of the abnormal shadow of the chest X-ray film. Left upper lobectomy was carried out for the lung carcinoma. Because of dysphagia after surgery, upper GI series and endoscopic biopsy were performed, and midesophageal carcinoma was revealed. Radical operation of the esophageal carcinoma was performed 2 months after the first operation. Pathological diagnosis of the lung tumor and the esophageal tumor were well differentiated adenocarcinoma and moderately differentiated squamous cell carcinoma respectively and both of them were early cancer. After 22 months of the second operation, he is doing well. Case 2. a 66-year-old man was operated on because of the esophageal carcinoma in other hospital. Abnormal shadow appeared in his X-ray film 10 months after operation. Although he received chemotherapy as metastatic lung cancer, bronchoscopic examination revealed it adenocarcinoma. We performed segmental lobectomy to him 17 months after the first operation. Pathological diagnosis was large cell carcinoma of the lung. He is also doing well 18 months after the second operation.
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PMID:[Two surgical cases of synchronous double carcinoma of the lung and esophagus and review of 10 documented cases in Japan]. 185 97


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