Zenker's diverticulum, a pulsion diverticulum of the hypopharynx, is a rare lesion that commonly occurs in left side of hypopharynx. The incidence of esophageal diverticula is much lower than that of focal lesions or nodules of thyroid. In an ultrasonography, the outpouching just like a focal thyroid lesion, may present as an oval or circular structure. The food remnants or gas bubbles present in the diverticulum may mimic microcalcifications presented in papillary thyroid carcinoma. We reported a case of right side Zenker's diverticulum mimicking a thyroid cancer in thyroid ultrasonography.
Diverticulum ; Diverticulum, Esophageal ; Hypopharynx ; Incidence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography ; Zenker Diverticulum

Advances in diagnostic modalities and improvement in surveillance programs for Barrett esophagus has resulted in an increase in the incidence of superficial esophageal cancers (SECs). SEC, due to their limited metastatic potential, are amenable to non-invasive treatment modalities. Endoscopic ultrasound, endoscopic mucosal resection, and endoscopic submucosal dissection (ESD) are some of the new modalities that gastroenterologists have used over the last decade to diagnose and treat SEC. However, esophageal stricture (ES) is a very common complication and a major cause of morbidity post-ESD. In the past few years, there has been a tremendous effort to reduce the incidence of ES among patients undergoing ESD. Steroids have shown the most consistent results over time with minimal complications although the preferred mode of delivery is debatable, with both systemic and local therapy having pros and cons for specific subgroups of patients. Newer modalities such as esophageal stents, autologous cell sheet transplantation, polyglycolic acid, and tranilast have shown promising results but the depth of experience with these methods is still limited. We have summarized case reports, prospective single center studies, and randomized controlled trials describing the various methods intended to reduce the incidence of ES after ESD. Indications, techniques, outcomes, limitations, and reported complications are discussed.
Barrett Esophagus ; Esophageal Neoplasms ; Esophageal Stenosis* ; Humans ; Incidence ; Polyglycolic Acid ; Prospective Studies ; Stents ; Steroids ; Ultrasonography

Metastatic cancer to the esophagus is rare and the breasts are the most common primary tumors that metastasize to the esophagus. Since metastatic breast cancer is located in the submucosal layer, diagnosis by general forceps biopsy is difficult. Hence, various techniques including endoscopic ultrasound guided fine needle aspiration, endoscopic ultrasound guided fine needle biopsy, unroofing technique, and submucosal tunneling method are used for diagnosis. Moreover, the patient's medical history should be inspected carefully and previous histological findings of cancer should also be evaluated. Herein, the authors report a case of metastatic breast cancer along with literature reviews. Endoscopy was performed in patient who had undergone breast cancer surgery 13 years previously. Histological examination from a midesophageal stricture was normal. Endoscopic ultrasound was performed and uneven hypoechoic masses were found in the third layer of the esophageal wall. The esophageal stricture was finally diagnosed as metastatic breast cancer by endoscopic ultrasound-guided fine needle biopsy.
Biopsy ; Biopsy, Fine-Needle* ; Breast ; Breast Neoplasms* ; Constriction, Pathologic ; Diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endoscopy ; Endosonography ; Esophageal Stenosis* ; Esophagus ; Humans ; Neoplasm Metastasis ; Surgical Instruments ; Ultrasonography*

PURPOSE: Thyroid nodules are a common disease in clinical practice. The prevalence of thyroid nodules has recently increased according to the development of thyroid ultrasonography. Thyroid nodules are more commonly found in women, but the potential for malignant nodules is much higher in men. The purpose of this study was to assess clinical characteristics and the incidence of thyroid nodules and malignancy in the adult male population. METHODS: Clinical characteristics and incidence of thyroid nodules was examined by screening ultrasonography targeting 6,968 male patients over the age of 40 who visited the National Police Hospital from January 2012 and April 2015. RESULTS: Among 6,968 male patients, 2,481 (35.6%) showed abnormal findings on ultrasonography. Of the 2,481 patients, 2,370 patients (34.01%) had a thyroid nodule and 111 patients (4.47%) had thyroiditis without a thyroid nodule, previous thyroidectomy, lymphadenopathy, esophageal diverticulum, parathyroid cyst, and benign calcification. Of the 2,481 patients, 958 patients (38.6%) had abnormal TFT and 204 patients (8.22%) had thyroiditis with or without a thyroid nodule. Thyroid nodules were benign in 1993 (80.33%) cases, indeterminate in 313 (12.61%) cases, and suspicious in 64 (2.56%) cases. Among the 2,481 subjects, thyroid cancer was detected in 37 subjects (1.49%). CONCLUSION: The incidence of thyroid nodules has recently increased according to the development of thyroid ultrasonography.
Adult ; Diverticulum, Esophageal ; Female ; Humans ; Incidence* ; Lymphatic Diseases ; Male* ; Mass Screening ; Police ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule* ; Thyroidectomy ; Thyroiditis ; Ultrasonography

BACKGROUND/AIMS: Submucosal tumors of the esophagus are rare lesions among all esophageal neoplasms. The purpose of this study was to evaluate the clinicopathologic features of esophageal submucosal tumors treated by surgical approach. METHODS: We analyzed the clinicopathologic and endoscopic ultrasonographic features of 18 esophageal submucosal tumors which were treated by surgical approach at Boramae Medical Center and Seoul National University Bundang Hospital from January 2005 to June 2012. RESULTS: The mean age was 48.9 years old and male to female ratio was 2.6:1. Asymptomatic patients were most common (77.8%). In endoscopic ultrasonographic finding, the majority tumor arouse in the middle (55.6%) and lower (44.4%) esophagus, and appeared as hypoechoic lesion (72.2%) in the 4th layer (83.3%). The most common indication for surgical approach was unclear biological behavior of the tumor. Minimally-invasive technique using thoracoscopy was applied for the enucleation (83.3%). The mean diameter of the tumor was 5.4 cm, and the final diagnosis was leiomyoma (89.9%) and gastrointestinal stromal tumor (11.1%). CONCLUSIONS: Leiomyoma was the most common submucosal tumor in esophagus. However, endoscopic ultrasonography was not able to differentiate between leiomyoma and gastrointesinal stromal tumor. For more accurate diagnosis and treatment, minimally-invasive approaches may be suitable for the surgical enucleation of indicated esophageal submucosal tumor.
Adult ; Aged ; Esophageal Neoplasms/*pathology/*surgery/ultrasonography ; Esophagus/pathology ; Female ; Gastrointestinal Stromal Tumors/diagnosis/surgery ; Humans ; Intestinal Mucosa/*pathology ; Leiomyoma/diagnosis/surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracoscopy

The technique of endoscopic submucosal dissection is occasionally used for resection of myogenic tumors originating from muscularis mucosa or muscularis propria of stomach and esophagus. However, endoscopic treatments for esophageal myogenic tumors >2 cm have rarely been reported. Herein, we report a case of large leiomyoma originating from muscularis propria in the upper esophagus. A 59-year-old woman presented with dysphagia. Esophagoscopy and endoscopic ultrasonography revealed an esophageal subepithelial tumor which measured 25x20 mm in size, originated from muscularis propria, and was located at 20 cm from the central incisors. The tumor was successfully removed by endoscopic submucosal dissection and there were no complications after en bloc resection. Pathologic examination was compatible with leiomyoma.
Esophageal Neoplasms/*diagnosis/pathology/surgery ; Esophagus/surgery/ultrasonography ; Female ; Gastroscopy ; Humans ; Leiomyoma/*diagnosis/pathology/surgery ; Middle Aged ; Mucous Membrane/pathology ; Stents ; Tomography, X-Ray Computed

Patients with late-stage cancer commonly have distant lymph node metastasis; however, poor health often contraindicates surgical treatment. Although the quality of life and overall survival for these patients are low, there is neither a consensus nor a guide for treatment. Ablation technique and surrounding tissue damage are two possible reasons for limited study of radiofrequency ablation in patients with superficial distant lymph node metastasis. Here, we report two patients treated successfully with ultrasound-guided radiofrequency ablation for superficial distant lymph node metastasis. In these patients, deionized water was injected to the surrounding tissues of the lymph node to decrease heat injury. Results from these patients suggest that radiofrequency ablation may play an important role in the treatment of patients with distant lymph node metastasis.
Catheter Ablation ; methods ; Esophageal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Neoplasm Staging ; Ultrasonography, Interventional ; methods

No abstract available.
Bone Neoplasms/diagnosis/secondary ; Combined Modality Therapy ; Esophageal Neoplasms/*diagnosis/radiotherapy/ultrasonography ; Esophagoscopy ; Humans ; Male ; Melanoma/*diagnosis/radiotherapy/ultrasonography ; Middle Aged ; Neoplasm Metastasis ; Positron-Emission Tomography ; Recurrence ; Tomography, X-Ray Computed

No abstract available.
Bone Neoplasms/diagnosis/secondary ; Combined Modality Therapy ; Esophageal Neoplasms/*diagnosis/radiotherapy/ultrasonography ; Esophagoscopy ; Humans ; Male ; Melanoma/*diagnosis/radiotherapy/ultrasonography ; Middle Aged ; Neoplasm Metastasis ; Positron-Emission Tomography ; Recurrence ; Tomography, X-Ray Computed

No abstract availble.
Adult ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Esophageal Neoplasms/*diagnosis/pathology/surgery ; Esophagectomy ; Esophagus/*pathology/ultrasonography ; Humans ; Male ; Mucous Membrane/pathology