neuroace

MBBS VI
5+ Year Member
Oct 10, 2015
59
9
Status
Medical Student
A 73-year-old man presents to his general practitioner complaining of difficulty swallowing for 3 months. He first noticed problems with solid foods “taking a long time to go down if I was in a hurry and didn’t chew them properly” with associated discomfort mid chest. The problem has been getting progressively worse so that now he even has difficulty swallowing liquids and occasionally coughs after drinking. He has also noticed that his clothes are looser on him than before.

He has a 50 pack-year smoking history and has drunk 6 units of alcohol a day for the past 40 years.

His vital signs are normal. His physical examination showed that he is miserable and gaunt with a palpable mass in the right upper quadrant which moves down on inspiration.

An upper GI endoscopy was performed showed an eccentric posterior ulcerated exophytic mass narrowing the lumen of the oesophagus at 26cm from incisors. A transoesophageal ultrasound showed disruption of the muscularis propria by the lesion and enlargement of the paraoesophageal lymph nodes. Biopsy of the mass shows the features below.

1st pic of: [ Lung cancer pptx - د. حسن اسماعيل ]. The site says SCC.. but I guess it could be SCC of esophagus [other answer]

What is the most likely diagnosis in this case?

I thought it was SCC of Lung .. but others disagree.
 
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