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Case data
Male, 63 years old, with 3 months of poor swallowing, aggravated by 1 week of medical attention
Barium upper gastrointestinal meal: a large fusiform filling defect is seen in the lumen of the subthophagus thorax, about 9 cm long, the boundary with the adjacent normal esophagus is clearer, the tube wall is still soft, no obvious signs of obstruction are seen through the contrast medium, and the mucosal interruption is destroyed (Figure 1
Fig.
MRI: fusiform abnormal signal shadow in the lumen of the suborgusophagus of the esophagus, and no significant abnormality
Figures 2 to 6 are T1WI transverse fault, DWI transverse fault, T2WI sagittal position, enhanced scanning arterial sagittal position, enhanced scanning delayed sagittal position; Lesion T1WI is dominated by equal signals, DWI and sagittal T2WI are mainly slightly higher signals, the arterial stage of enhanced scanning is uneven and significantly strengthened, the degree of reinforcement is higher than that of the adjacent normal esophageal wall, the degree of reinforcement of the lesion is unevenly increased in delayed scanning, and the difference with the normal esophageal wall is reduced (arrow)
Intraoperative: Esophageal subthoracic segment sees a umbelous mass of about 9.
Fig.
One tumor metastasis was seen in the "paraesophageal" lymph nodes, 4 "sub-bulge" lymph nodes, and 1 "left gastric" lymph node
Discuss:
Esophageal sarcoma-like carcinoma is a rare esophageal malignancy that occurs more often in men around the age of 60 years, making early diagnosis difficult and mostly presenting for progressive dysphagia
MRI can be imaged in multiple directions, and the T2WI sagittal position helps to visually determine the length of the lesion and observe whether adjacent structures are invaded
When the lesion of mushroom-type esophageal cancer is larger, the tube wall is stiff, the lumen is narrow, the obstruction is obvious, the boundary between the tumor and the muscular layer of the tube wall is not clear, and some adjacent tissue invasion can be observed, and the invasive tube wall and adjacent tissue are strengthened
