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Esophageal Neoplasia 309.e5

Esophageal Neoplasia Client Education
Sheet
VetBooks.ir Diseases and Disorders
PHYSICAL EXAM FINDINGS
BASIC INFORMATION
• Rarely, a palpable mass may be found in the • Fecal flotation may show S. lupi ova, although
a negative test does not rule out infection
Definition ventral cervical region. Most often, however, because esophageal neoplasia may form long
Benign or malignant tumor of the esophagus, no significant physical abnormalities are after initial exposure.
including Spirocerca lupi infection found. • Cytology of enlarged lymph nodes to dif-
• Thin body condition ferentiate reactive lymphadenopathy from
Epidemiology • Melena metastasis
SPECIES, AGE, SEX • Back pain from spondylitis of the caudal
• Rare in dogs and cats thoracic vertebrae caused by spirocercosis Advanced or Confirmatory Testing
• Older animals predisposed, although benign • CT or MRI to better delineate a mass when
Spirocerca-induced nodules often occur in Etiology and Pathophysiology radiographs are equivocal
young to middle-aged dogs • Sarcoma formation has been correlated to • Pneumoesophagography may help visualize
• Overall, there is no sex predisposition for infection with S. lupi. lesions
esophageal neoplasia. However, Spirocerca- • Metastasis to the esophagus from primary • Endoscopic biopsies; generally nondiagnostic
induced sarcomas occur more commonly in thyroid gland or mammary gland tumors for submucosal lesions
female dogs, and squamous cell carcinoma is more common than primary esophageal • Exploratory surgery for histopathology if
is more common in female cats. neoplasia. samples obtained during esophagoscopy
• Primary esophageal malignancies may metas- are nondiagnostic
GENETICS, BREED PREDISPOSITION tasize to regional lymph nodes or lungs, less
No breed predisposition commonly to other organs. TREATMENT

RISK FACTORS DIAGNOSIS Treatment Overview
Spirocerca lupi infection, resulting in forma- Goals of treatment are relief of signs of partial
tion of a benign fibromatous nodule that may Diagnostic Overview esophageal obstruction and delay or prevention
transform into a malignant sarcoma Confirmation of diagnosis requires histopathol- of disease progression.
ogy and often must be obtained surgically.
GEOGRAPHY AND SEASONALITY Acute General Treatment
Areas where S. lupi is endemic, including the Differential Diagnosis • Surgery when feasible; in general, it is dif-
Middle East, Africa, and the southeastern Any disease causing signs of partial esophageal ficult due to length of resection required in
United States obstruction or megaesophagus advanced cases and inability to obtain good
exposure of the esophagus. Esophagotomy
ASSOCIATED DISORDERS Initial Database for localized resection may be possible for
Hypertrophic osteopathy has been reported, • Plain radiographs of the thorax (three well-circumscribed and/or pedunculated
especially in S. lupi–induced sarcomas. views) and neck may show repeatable, lesions.
excessive gas in the esophagus, a mass, or • Placement of gastrostomy tube for
Clinical Presentation megaesophagus, all proximal (orad) to the feeding
DISEASE FORMS/SUBTYPES obstruction. In cases with S. lupi–induced
• The most common primary esophageal sarcomas, the most common radiographic Chronic Treatment
tumors are squamous cell carcinoma (cats), abnormalities are a mass in the caudodorsal • Chemotherapy for malignant esophageal
leiomyosarcoma (dogs), osteosarcoma, aspect of the mediastinum. Other anatomic neoplasia to delay recurrence or resected
fibrosarcoma, and anaplastic sarcomas; locations are possible. Masses may displace or lesion or development of metastatic disease,
rarely, benign tumors such as leiomyoma compress the main stem bronchus. Thoracic but benefit is unknown
or plasmacytomas may occur. vertebral spondylitis occurs commonly • Palliative radiation therapy for cervical
• Primary thyroid gland or mammary gland in dogs with S. lupi–induced sarcomas esophageal masses
tumors may metastasize to the esophagus. (generally spondylitis of caudal thoracic • Avermectins to treat benign spirocercosis
• Lymphoma may involve the esophagus, and vertebrae). • Photodynamic therapy may be considered
when it does, multicentric lymphoma usually ○ Lung fields should be evaluated for for superficial mucosal tumors, but efficacy
is present. metastases in all patients with esophageal unknown
• Primary tumors arising from the thymus, masses.
heart base, or thyroid gland may extend • Barium swallow may be useful to show an Nutrition/Diet
directly into the esophagus. esophageal stricture or mass. • Nutritional palliation with placement of
• Esophagoscopy to visualize mass(es); often feeding tubes
HISTORY, CHIEF COMPLAINT irregular and ulcerated, but leiomyomas and • Offering a variety of food textures and
• Weight loss benign nodules are usually submucosal, well elevated feedings may be necessary for dogs
• Discomfort with swallowing circumscribed, and not attached to overlying with megaesophagus.
• Dysphagia mucosa.
• Regurgitation • Biopsy for histopathologic evaluation, with Behavior/Exercise
• Coughing/retching samples usually obtained at the time of No restrictions in activity are recommended.
• Lethargy, fever, inappetence, dyspnea, cough esophagoscopy
(aspiration pneumonia) • CBC, serum biochemical profile, and uri- Possible Complications
• Less commonly, lameness or pain of the nalysis are usually normal, although some • Short-term dehiscence or long-term stricture
extremities associated with hypertrophic patients may be anemic due to chronic blood formation after esophageal surgery
osteopathy loss from friable esophageal tumors. • Risks associated with thoracotomy

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