Dysphagia in the elderly is often a serious complaint, indication stenosis due
to longstanding reflux disease, or as in this case, a malignant tumour in the
oesophagus
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Oesophageal Carcinoma
The oesophageal lumen can sometimes be quite narrowed by a malignant disease
before the patient seeks medical advice - as in this case, with a malignant
stricture 25 cm from the tooth level.
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Radical surgical curative treatment is often not possilble due to the age of the patient and concommitant diseases. Palliation can be achieved by radiation therapy and endoscopic therapy of different kinds.
A typical x-ray- and endoscopic finding in an advanced oesophageal carcinoma.
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A small Oesophageal Cancer
This quite small oesophageal cancer is situated in the middle third of the oesophagus.
Effect of Radiation and Cytostatic Treatment
Conservative treatment can sometimes be strikingly effective. This patient had a large tumor, completely obstructing his oesophagus. This is the finding after treatment, a small scar tissue is visible to the left in these pictures, but the lumen is open, the patient can eat quite normally and normal food and is gaining weight.
The Incidence of Oesophageal Cancer
The incidence of oesophageal squamous cell cancer is fortunately going down in Finland and other industrialized countries. However, this decline in incidence is somewhat compensated by a rise in oesophageal adenocarcinoma.
A typical quite early oesophageal squamocellular cancer in the middle third of the oesophagus