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Esophageal Adenocarcinoma Characteristics and Presentation

Sarcophagus Add (+) Car-Gnome with Tumor-Guy
CristianCazac
Esophageal adenocarcinoma is the most common type of esophageal cancer in the United States (squamous cell carcinoma being the most common worldwide). This subtype typically arises in the lower 1/3 of the esophagus. Risk factors include gastroesophageal reflux disease, Barrett's esophagus, achalasia, obesity and smoking, as these can cause chronic damage to the esophagus and can predispose patients to neoplasia. Patients can present with weight loss, progressive dysphagia, and anemia.
10 KEY FACTS
CHARACTERISTICS
Most Common Esophageal Cancer in USA
#1 Foam-finger American Flag

Adenocarcinoma of the esophagus is more common in America than squamous cell carcinoma of the esophagus. However, squamous cell carcinoma of the esophagus is more common overall worldwide.

Lower 1/3 of Esophagus
Lower (1) Wand and (3) Tree with Sarcophagus

This disease typically arises in the lower 1/3 of the esophagus. Contrast this with esophageal squamous cell carcinoma, which typically arises in the upper 2/3 of the esophagus.

RISK FACTORS
Gastroesophageal Reflux Disease (GERD)
Girdle-girl

Long-standing GERD can cause chronic damage to the lower esophagus due to gastric acid reflux. Untreated, this damage can lead to cellular changes which can later become adenocarcinoma of the esophagus.

Barrett's Esophagus
Bear-ette's Sarcophagus

Barrett's Esophagus refers to the changes in the epithelium lining the lower esophagus. Conditions such as long-standing GERD cause gastric acid to reflux into the lower esophagus damaging it. The cells of the lower esophagus change as a result of this damage from squamous epithelium to columnar epithelium. The process of cells changing into a different subtype is called metaplasia.

Achalasia
A-collar-and-leash

Achalasia refers to the failure of the lower esophageal sphincter to relax thus leading to food and drink being trapped in the lower 1/3 of the esophagus.

Obesity
Obese People

Obesity is a risk factor for developing adenocarcinoma of the esophagus.

Smoking
Cigarette

Smoking causes chronic damage to the esophagus. Smoking is a significant risk factor for the development of adenocarcinoma of the esophagus.

PRESENTATION
Weight Loss
Skinny with Baggy-Pants

Weight loss is a common symptom in 57% to 85% of patients. Progressive dysphagia leads to decreased food intake causing weight loss. Other reasons for weight loss include systemic inflammation due to the neoplasia itself as well as psychological factors.

Progressive Dysphagia
Dice-fajita with Solids and Liquids

Dysphagia is defined as difficulty swallowing food. As the adenocarcinoma grows, it tends to obstruct the esophageal lumen thus preventing food from passing through to the stomach. The dysphagia is typically progressive to solid foods first and then to liquids.

Anemia
Anemone

Patients may experience iron-deficiency anemia due to chronic blood loss.

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