CARCINOMA OF THE OESOPHAGUS : AETIOPATHOGENESIS , SITES , TYPES

 Aetiopathogenesis : 

  1. Pre-cancerous / predisposing conditions :
            (a) Reflux oesophagitis with Barrett's oesophagus .
            (b) Plummer vinson syndrome with squamous metaplasia .
            (c) Achalasia cardia .
            (d) Corrosive cardia .
            (e) Familial keratosis palmaris or plantaris - It is a condition inherited as an autosomal dominant trait . It has increased incidence of oesophageal cancer .
 2.Possible aetiological factors :
            (a) Heavy smoking tobacco chewing  ,spicy food with spirits & alcohol abuse increase risk by 25-100 fold .
            (b) Fungal contamination of food with mycotoxins & nutritional deficiencies is responsible for oesophageal cancer in endemic areas .

Sites : 

  1. Middle 1/3rd of oesophagus .
  2. Lower 1/3rd of oesophagus .
  3. Upper 1/3rd of oesophagus .

Types ( Squamous cell carcinoma ) :

  1. Epitheliomatous ulcer with raised edges & flat base .
  2. Proliferative growth with surface ulcer which commonly bleeds .
  3. Infiltrative variety or annular stenosing variety .
  4. Polypoidal lesions .