CASE 168 35-year-old man with dysphagia, weight loss, and halitosis PA (Fig. 168.1) and lateral (Fig. 168.2) chest radiographs demonstrate a large, elongate middle-posterior mediastinal mass that extends to the paravertebral region, projects to the right of midline, and produces mass effect on the posterior wall of the trachea (Fig. 168.2). Contrast-enhanced chest CT (mediastinal window) (Figs. 168.3, 168.4) shows heterogeneous contents and dependent contrast in a dilated esophagus that produces mass effect on the heart and tracheobronchial tree (Fig. 168.4). Achalasia • Esophageal Dilatation from Progressive Systemic Sclerosis • Esophageal Dilatation from Acquired Focal Obstruction Fig. 168.1 Fig. 168.2 Fig. 168.3 Fig. 168.4
Clinical Presentation
Radiologic Findings
Diagnosis
Differential Diagnosis
Carcinoma
Metastatic Disease
Non-Neoplastic Stenosis
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