Pathology - Esophageal Carcinoma The risk factors encompass Barrett esophagus, achalasia, smoking, corrosive esophagitisdiverticula, esophageal webs, alcohol usage, and genetic predisposition. Most commonly observed in males between the ages of 50 and 70. Squamous cell carcinoma (SCC): Grossly, it originates in the upper and middle thirds of the esophagus. It might manifest as a polypoid lesion, diffuse infiltrating lesion, or necrotic ulceration. The tumor cell clusters are microscopic and consist of dysplastic squamous epithelium with keratin around. Adenocarcinoma: Macroscopic examination reveals its origin in the distal portion of the esophagus, typically developing from Barrett esophagus. It presents as an elevated area that can progress into a nodular tumor with ulceration. The glandular formation consists of cells that produce mucin and can only be observed under a microscope. The individual experiences difficulty swallowing solid food, which later extends to difficulty swallowing liquids. This condition is accompanied by weight loss, loss of appetite, hoarseness, pain, and vomiting blood. The development of a tracheoesophageal fistula might result in symptoms such as coughing or pneumonia. The majority of individuals exhibit advanced, untreatable illness. Palliative care refers to medical treatment aimed at relieving symptoms and improving the quality of life for patients with serious illnesses. Surgical resection involves the removal of diseased tissue through a surgical procedure. Chemotherapy is a treatment method that uses drugs to kill cancer cells. Radiation therapy uses high-energy radiation to destroy cancer cells and shrink tumors. The overall 5-year survival rate is less than 15%. Squamous cell carcinoma (SCC) is responsible for 90% of esophageal malignancies worldwide. However, in the United States, the prevalence of SCC and adenocarcinoma of the esophagus is approximately similar.
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