Presentation
A patient presented with chest discomfort, dysphagia for solids, and a negative cardiac workup.
Patient Data
There is a short area of abrupt change in esophageal luminal caliber with shouldering giving the appearance of an apple core, associated with mild prestrictural dilatation of the distal esophagus.
The background mucosa appears normal.
Moderately differentiated adenocarcinoma of the lower esophagus.
Case Discussion
Dysphagia is a relatively common complaint that may be functional or due to organic pathology, and among the feared causes of dysphagia are esophageal tumors.
Circumferential growth of tumors within the wall of hollow organs is the basis of the apple core appearance.
As seen in this case, the typical appearance of a neoplastic/infiltrative process is the sudden, sharp change in the width of the contrast agent column.
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