Pseudoachalasia Secondary to Metastatic Breast Carcinoma

J, Paulsen; Aragon, George; Ali, M; Brody, Fred; Borum, Marie

doi:10.1007/s10620-009-0809-1

Cited by 15 publications

(12 citation statements)

References 13 publications

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“…Rarely a peptic stricture can result in a reversible achalasia-like motor pattern [42]. However, in about 70% of affected patients, pseudoachalasia is caused by a primary or secondary malignancy [43,44] with primary malignancy accounting for 54-70% [44][45][46] and secondary malignancy for 6% of cases [47]. Pseudoachalasia as a manifestation of a malignancy was first described by Howarth in 1919 [48] and later by Ogilvie [49].…”

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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Section: Discussionmentioning

confidence: 99%

Pseudoachalasia as First Manifestation of a Malignancy

Fabian¹,

Eherer

Lackner

et al. 2019

Dig Dis

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“… 3 6 8 While many forms of malignancy can metastasize to the esophagus, only 6% of pseudoachalasia cases are secondary to metastatic versus primary disease. 4 Differentiation of primary from secondary achalasia has critical implications for patient management because of vastly different approaches for the work-up and treatment of these conditions.…”

Section: Discussionmentioning

confidence: 99%

“… 3 Therefore, most of the malignant tumors associated with secondary achalasia are adenocarcinomas of the esophagogastric (EG) junction, which account for more than 70% of cases. 4 The remaining cases involve metastatic disease from the surrounding liver, mediastinum, or biliary cancer. Until now, few cases have been reported to be associated with pancreatic cancer.…”

Section: Introductionmentioning

confidence: 99%

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation

et al. 2015

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Secondary achalasia or pseudoachalasia is a rare esophageal motor abnormality, which mimics primary achalasia; it is not easily distinguishable from idiopathic achalasia by manometry, radiological examination, or endoscopy. Although the majority of reported pseudoachalasia cases are associated with neoplasms at or near the esophagogastric (EG) junction, other neoplastic processes or even chronic illnesses such as rheumatoid arthritis can lead to the development of pseudoachalasia, for example, mediastinal masses, gastrointestinal (GI) tumors of the liver and biliary tract, and non-GI malignancies. Therefore, even if a patient presents with the typical findings of achalasia, we should be alert to the possibility of other GI malignancies besides EG tumors. For instance, pancreatic cancer was found in the case reported here; only four such cases have been reported in the literature. A 47-year-old man was admitted to our center with a 3-month history of dysphagia. His endoscopic and esophageal manometric findings were compatible with primary achalasia. However, unresponsiveness to diverse conventional achalasia treatments led us to suspect secondary achalasia. An active search led to a diagnosis of pancreatic mucinous cystadenocarcinoma invading the gastric fundus and EG junction. This rare case of pseudoachalasia caused by pancreatic carcinoma emphasizes the need for suspecting GI malignancies other than EG tumors in patients refractory to conventional achalasia treatment.

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“…Achalasia is a clinical diagnosis referring to incomplete relaxation of the lower oesophageal sphincter (LES) with impairment of oesophageal motility 1–5. There are two types of achalasia: primary and secondary.…”

Section: Introductionmentioning

confidence: 99%

Pseudoachalasia secondary to metastatic bladder cancer

Haberstroh

Shafa

2019

BMJ Open Gastroenterol

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Pseudoachalasia, or secondary achalasia, is a clinical condition that must be distinguished from primary achalasia. Both diagnoses may present similarly, but the aetiology and management for each are drastically different. Most significantly, pseudoachalasia carries a high association with malignancy, most often with primary adenocarcinoma of the oesophagus or cardia. Our case involves a patient with signs and symptoms consistent with pseudoachalasia due to metastatic bladder cancer.

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Pseudoachalasia Secondary to Metastatic Breast Carcinoma

Cited by 15 publications

References 13 publications

Pseudoachalasia as First Manifestation of a Malignancy

Pseudoachalasia as First Manifestation of a Malignancy

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation

Pseudoachalasia secondary to metastatic bladder cancer

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