Carcinoma in a Pharyngo-esophageal Diverticulum

Carcinoma of the pharyngeal pouch

“…Clearly the tendency for pouches to trap liquid and food leads to chronic irritation and if this predisposes to malignancy, the longer the pouch is present the greater the chance of tumour arising. This accords with the long history present in many cases; for example, Garlock and Richter (1961) described a 70-year-old man who had had symptoms and X-ray evidence of a pharyngeal pouch eight years before he presented with malignancy within the pouch. Pierce and Johnson (1969) described a 55-year-old man who had an oesophageal diverticulum for 10 years prior to the onset of severe dysphagia.…”

Pharyngeal pouch carcinoma: two unusual cases

“…The defects described in the cases of Lieberson and Riese (1960) and Kune (1972) were in a similar position. In both the cases described by Morley (1945) and that reported by Donald and Huffman (1979), the filling defect occurred at the neck of the pouch, and in the 'upper' part of the diverticulum's lateral wall in that described by Garlock and Richter (1961). The tumour in the case reported here was in the anterior superior wall of the pouch and consisted of an irregular area only, not associated with a marked filling defect.…”

“…The presence of a filling defect on contrast radiology has suggested the diagnosis of a carcinoma in 13 cases as reported in the English literature (Vinson, 1927;Sparks, 1933;Hoover, 1945;Morley, 1945 [2 cases]; Lindskog and Stern, 1954;Lieberson and Riese, 1960;Garlock and Richter, 1961;Turner, 1963 (2 cases); Kune, 1972;Donald and Huffman, 1979;Huang et al, 1984). In a further case, disproportionate posttracheal widening was a feature associated with a carcinoma (Johnson and Curtin, 1985), albeit one that had been complicated by a retropharyngeal abcess.…”

Carcinoma epidermoide sobre un divertículo de Zenker

“…El esofagograma baritado, además de poner de manifiesto la existencia de un divertículo, puede proporcionar datos a cerca de su malignización como es la imagen de un defecto de repleción que permanece constante. Los restos alimenticios y la presencia de aire en el divertículo pueden simular esta imagen, pero típicamente se localizan en la parte superior del divertículo, mientras que el defecto de repleción producido por el tumor se localiza en el fundus o en la pared lateral del divertículo, generalmente en los dos tercios inferiores (25,26,33), aunque hay casos de carcinomas descritos sobre el cuello del saco diverticular (42,46). Para algunos autores, la esofagoscopia constituye una prueba diagnóstica esencial, exista sospecha de malignidad o como paso previo a la cirugía del divertículo no complicado ya que permite visualizar y si es necesario, biopsiar, la mucosa del mismo (23,25,26,29,33) opinión que nosotros también compartimos pero que en nuestro caso no fue posible realizar preoperatoriamente.…”