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Dr. Stephanie Heon (Hematology–Oncology): A 63-year-old woman was seen in the Cancer Center at this hospital for management of adenocarcinoma of the gastroesophageal junction.
The patient had been well until approximately 2 months before this evaluation, when chest and epigastric discomfort developed after she ate solid foods, lasting from minutes to an hour. She had no difficulty swallowing liquids. Eighteen days before this evaluation, radiographs of the upper gastrointestinal tract, obtained at another hospital, showed severe erosive changes in the distal esophagus, an eccentric filling defect in the anterolateral portion of the esophagus, and minimal gastroesophageal reflux. Three days later,
Differential Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Divisions of Hematology–Oncology (E.L.K.) and Gastroenterology (D.G.F.), Department of Medicine, and the Departments of Radiation Oncology (T.S.H.), Surgery (D.L.B.), Radiology (R.N.U.), and Pathology (G.Y.L.), Massachusetts General Hospital; and the Departments of Medicine (E.L.K., D.G.F.), Radiation Oncology (T.S.H.), Surgery (D.L.B.), Radiology (R.N.U.), and Pathology (G.Y.L.), Harvard Medical School.
Related Letters:
Case 19-2009: Carcinoma of the Gastroesophageal Junction
van der Vliet H. J., van der Peet D. L., Verheul H. M.W., Hong T. S., Kwak E. L.
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N Engl J Med 2009;
361:1315-1316, Sep 24, 2009.
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