A Case of Esophageal Achalasia Associated With Sarcoidosis Treated by Laparoscopic Surgery

Saito, Shin; Hosoya, Yoshinori; Ui, Takashi; Akira, Tanaka; Sata, Naohiro; Yasuda, Yoshikazu

doi:10.3919/jjsa.72.54

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…It appears that the main cause of pseudoachalasia is an adenocarcinoma at the GEJ; however, similar effects have been also reported with multiple other cancers such as lung, pancreatic, breast, and cervical cancers, pleural mesothelioma, and multiple myeloma [14][15][16][17][18][19][20][21]. Nonmalignant causes of pseudoachalasia include, but are not limited to, amyloidosis, sarcoidosis, thoracic aortic aneurysm, systemic mastocytosis, Chagas disease, neurofibromatosis, histiocytosis-x, and Fabry disease with the accumulation of lysosomal Gb3 [6,[22][23][24][25][26][27][28][29]. Anti-reflux surgery can also lead to pseudoachalasia due to misdiagnosed idiopathic achalasia with dysphagia symptoms postoperatively, underlying gastroesophageal reflux leading to achalasia, and an excessively tight fundic wrap or scar tissue development postoperatively.…”

Section: Discussionmentioning

confidence: 80%

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Miranda,

Azad,

Moyer

et al. 2024

Cureus

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Pseudoachalasia is a condition in which symptoms, manometry, and imaging findings highly resemble primary achalasia but has a secondary etiology. The majority of patients with pseudoachalasia have the condition as the result of a malignancy, most often at the gastroesophageal junction. There may be issues with timely identification of this malignancy as symptoms are often obscure with diagnostic testing yielding nonspecific results. We describe a case of a 65-year-old diabetic female smoker with a four-month history of intractable vomiting, abdominal pain, and weight loss who was belatedly found to have an adenocarcinoma at the gastric cardia necessitating a total gastrectomy and chemotherapy administration. The case educates clinicians on the clinical alarm symptoms related to malignant pseudoachalasia and stresses the paramount importance of performing a timely esophagogastroduodenoscopy in all cases of achalasia, even with seemingly normal imaging, to rule out pseudoachalasia related to malignancy.

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Section: Discussionmentioning

confidence: 80%

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Miranda,

Azad,

Moyer

et al. 2024

Cureus

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“…A large spectrum of underlying causes has been reported, including thoracic aortic aneurysm [30], rheumatoid arthritis [31], previous Nissen fundoplication [32], bariatric surgery and adjustable gastric band placement [33,34], amyloidosis [35,36], sarcoidosis [37], systemic mastocytosis [38], intestinal pseudoobstruction [39], and Chagas disease [40]. In Fabry disease, the accumulation of lysosomal Gb₃ (globotriaosylceramide) leads to neuronal and vascular dysfunction that may also cause pseudoachalasia [41].…”

Section: Discussionmentioning

confidence: 99%

Pseudoachalasia as First Manifestation of a Malignancy

Fabian¹,

Eherer

Lackner

et al. 2019

Dig Dis

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Pseudoachalasia is a condition in which symptoms, radiologic, endoscopic, and manometric findings mimick idiopathic achalasia. About 4% of patients with a typical constellation for idiopathic achalasia will turn out to have pseudoachalasia, posing a major diagnostic challenge. A large spectrum of underlying causes of pseudoachalasia has been described. However, in about 70% of affected patients, this condition is caused by a malignancy (mostly adenocarcinoma of the esophagogastric junction or cardia). We describe a 16-year-old high school student referred for management of achalasia who turned out to have pseudoachalasia due to adenocarcinoma of the cardia. He was cured with preoperative chemotherapy followed by radical surgery. Therapy of pseudoachalasia secondary to neoplasia is directed against the tumor or may be palliative to keep the lumen open. Other causes of pseudoachalasia include esophageal motility disturbances as a paraneoplastic phenomenon (e.g., with small cell lung cancer), post fundoplication or post bariatric surgery, in association with a thoracic aortic aneurysm, or with sarcoidosis or amyloidosis. Therapy is directed accordingly to eliminate or correct the underlying cause.

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A Case of Esophageal Achalasia Associated With Sarcoidosis Treated by Laparoscopic Surgery

Cited by 2 publications

References 5 publications

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia

Pseudoachalasia as First Manifestation of a Malignancy

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