Dysphagia and esophageal stenosis.Manifestation of metastatic mammary cancer

Abstract

A remarkably uniform syndrome of dysphagia due to metastatic carcinoma of the breast situated in submucosal lymphatics of the middle third of the esophagus or in adjacent mediastinal lymph nodes has been described. Diagnostic features include the smooth apparently extrinsic nature of the tumor and the concentric stenosis with intact esophageal mucosa encountered endoscopically. Specific treatment of this particular complication seems indicated because several patients have sustained considerable benefit from an aggressive attack upon the lesion. Irradiation to the posterior mediastinum is the treatment of choice, with surgical excision or bypass an acceptable alternative. Whether this pattern of metastases represents chance occurrence or a secondary pathway of importance remains to be determined.