esophageal tumors

BACKGROUND

Esophageal tumors are very rare in both cats and dogs. The majority of esophageal tumors are malignant and include a variety of carcinomas and sarcomas. In endemic areas (south-east USA, Israel and Africa), esophageal sarcomas are caused by parasitic infestation (Spirocerca lupi). Benign tumors, such as leiomyomas and extramedullary plasmacytomas, are occasionally reported and have a predilection for the distal esophagus and gastric cardia.

DIAGNOSIS

Diagnostic tests include endoscopy, contrast radiographs (or barium study), and ultrasonography. While endoscopy is an excellent diagnostic tool, endoscopic biopsies are often too small to provide a definitive diagnosis. In these cases, a preoperative diagnosis may not be possible and surgery may be required for both the diagnosis and treatment of esophageal tumors.

CLINICAL STAGING

An abdominal ultrasound is recommended to check for metastasis to the regional lymph nodes and liver. Chest radiographs or CT scans are done to check for metastasis to the lungs.

TREATMENT

Esophageal tumors, if possible, are treated with wide surgical excision, including margins of 3-5 cm. However, this may not be possible for some esophageal tumors because the defect may be too large for end-to-end anastomosis without significant tension and risk of life-threatening complications. Excision with minimal margins followed by postoperative chemotherapy with doxorubicin is recommended in these cases.

PROGNOSIS

The prognosis is fair to guarded for dogs with malignant esophageal tumors. The median survival time for dogs with esophageal sarcomas treated with marginal surgical excision and chemotherapy is 267 days. Esophageal leiomyosarcomas are usually low grade and have survival times > 400 days following surgery alone.

To be updated