Esophageal Achalasia Probably Due to Gastric Carcinoma

Abstract

A case of invasive gastric carcinoma mimicked idiopathic achalasia. Esophagoscopy, cineradiography, exfoliative cytology, manometry, and the methacholine (Mecholyl⌖) test were consistent with idiopathic achalasia. Only a high index of suspicion based on the short duration of symptoms and particularly the suggestion of a fundal mass in the upper gastrointestinal series led to the correct diagnosis. The demonstrated carcinomatous involvement of the esophageal ganglia probably produced the achalasia.