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Julio Alejandro Murra-Saca MD.
Tel : (503) 2226-3131, (503 )2225-3087, Celular (503)7 887-2507
Edificio Centro Scan, Colonia Médica, San Salvador, El Salvador.


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Notes on Cyber Gastroenterology


One of the most aggressive cancers and malignant is that of the esophagus.Survival is rare.

In El Salvador is not frequent but we often observed , within our collection of video endoscopy we found several cases of primary , (Squamus cell carcinoma) this tumor are related to people who smoke and abuse of alcoholic drinks. Adenocarcinoma of the lower third is most frecuently.
Lye ingestion has been implicated as a risk factor of cancer of the esophagus.
Dysphagia is the classic symptom of esophageal carcinoma, It usually progresses gradually from difficulty with intake of solid food to soft foods and eventually to the inability to swallow liquids although esophageal cancer most often develops during the seventh decade of life, any adult with dysphagia should be presumed to have esophageal cancer until it is rule out.
Pain is common, usually located in the back or substernally; it is constant, ranges from mild to severe,and usually indicates extension of the tumor.Coughing is a common complaint and is most often secondary to aspiration although a tracheo- esophageal fistula may be present.Chronic heartburn may lead to a condition called Barrett's Esophagus which increases the risk of cancer 40-fold developing adenocarcinoma of the cardias and lower esophagus see gastric cancer.

The outcome of esophageal cancer is strongly associated with its stage. As a result, accurate clinical staging is critical for selecting an appropriate treatment option. Staging usually begins with a CT scan to evaluate for the presence of metastatic disease. Patients without evidence of metastatic disease by CT frequently undergo endoscopic ultrasonography (EUS), which uses a high frequency ultrasound transducer to provide detailed images of esophageal masses and their relationship with the five-layered structure of the esophageal wall.


as in this chapter and the clinical cases display here are of that Squamous cell carcinoma.

Esophageal Squamous Cell Carcinoma.

Ulcerating Squamous cell carcinoma of the lower end of the esophagus.

This 72 year-old female, presented with progressive dysphagia.


 Esophageal Squamous Cell Carcinoma of the the upper third of the Esophagus.

 This 83 year-old male who was referred to our endoscopic
 unit by the same otorhinolaryngologist that send to us the
 patient described in the previous endoscopic sequence,
 both patient were
referred in less than a month living in the
 same small city . This patient has a long history of
 tobacco and heavy alcoholism.

Small cell carcinoma: This tumor usually arises close to the hilum
Small cell carcinoma of the lung that invades the upper and the middle third of the Esophagus.

This view is from the upper esophageal sphincter.

Small cell carcinoma: This tumor usually arises close to
 the hilum. Is the most malignant lung cancer and is
 composed of oat cells which are smaller than tumor cells
 found in the squamous cell carcinoma and adenocarcinoma.
 The tumor cells have little cytoplasm, are arranged in
 clusters and nests, show arefactual smearing after
 processing, do not show evidence of squamous or glandular
 differentiation and have neurosecretory granules. The
 neurosecretory granules may be identified at the
 ultrastructural level or by immunohistochemical
 demonstration of chromogranin or synaptophysin. This is
 the type of the tumor that is associated with paraneoplastic

Middle third Esophageal Carcinoma please click the image to download the video clip.Click the image to see the video.
Esophagus Carcinoma of the middle third , 45 years-
old woman , with progressive dysphasia (difficulty of swallowing)
to solids, she was found to have this firm, mid esophageal mass
she refused the surgery and dies 15 days after the diagnosis.
Esophageal Squamous Cell Carcinoma


Middle third Esophagus Carcinoma.
67 years old female, with progressive dysphasia At the level of the middle third, these raised mass lesion can be observed ulcerated area and another mass nearby (left) , she had palpable abdominal metastasis. Esophageal Squamous Cell Carcinoma

Squamous cell carcinoma of the cardias.
Squamous cell carcinoma of the cardias.

Click the image to download the video clip.
82 yeas old man French. With progressive dysphagia (difficulty swallowing) to solids, who was found to have this firm superior third mass, causing high-grade obstruction of the esophageal lumen. Cancer caused esophageal perforation and mediastinitis.
Esophageal Squamous Cell Carcinoma .
For more endoscopic details please download the video clip by clicking on the image, to appreciate in full screen first wait to be downloaded complete and press on the media a click and press Alt And enter.


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