Infiltrative esophageal cancer: difficulties of endoscopic differential diagnosis

Introduction. Diffusely infiltrative esophageal cancer is extremely rare; publications are limited to descriptions of sporadic clinical observations. Differential diagnosis and morphological verification are extremely difficult, which lead to accurate diagnosis delays. This type of tumor growth can be both primary and secondary, for example, with metastasis of breast cancer. Aim. To consider various endoscopic semiotics of diffuse infiltrative esophageal cancer and analyze the difficulties of differential diagnosis with other pathological conditions of the esophagus based on our own experience. Materials and methods. From 2013 to 2024 endoscopic examination suggested suspicion of infiltrative malignant lesion in 10 patients with complaints of dysphagia. A group of 14 patients with benign stenotic diseases of the esophagus was examined for the purpose of endoscopic differential diagnostics. Results. Based on the results of endoscopic, radiation and morphological diagnostic methods, 7 out of 10 patients were recommended to consult surgeons and oncologists. Self-expanding endoprostheses were installed in 3 patients. 1 of the 14 patients with benign stenosis of the esophagus was operated - enucleation with verified fibromyomatosis. The rest underwent bougienage or balloon dilation in combination with antisecretory, antacid and mucoprotective therapy with good results. In complex cases, the high efficiency of endoscopic treatment methods indicates the benign nature of the disease. However, it is extremely important not to lose vigilance and not to forget about the possibility of progression and malignancy with long-term tissue alteration. Conclusion. Infiltrative esophageal cancer is rare and difficult to diagnose. Disease progression and invasiveness determine an unfavorable prognosis. In order to reduce the percentage of late diagnosis and improve treatment results, close attention to all patients with dysphagia and their timely referral to expert institutions is required.

esophageal cancer, infiltrative cancer, scirrhus, linitis plastica, endoscopic differential diagnosis

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