Esophageal Cancer

“Esophageal cancer starts at the inside lining of the esophagus and spreads outward through the other layers as it grows. The two most common forms of esophageal cancer are named for the type of cells that become malignant are:

Squamous cell carcinoma: Cancer that forms in squamous cells, the thin, flat cells lining the esophagus. This cancer is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.

Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.

The National Cancer Institute estimates that some 21,560 people in the United States will be diagnosed with esophageal cancer in 2023, and 16,120 people will die of the disease. The average five-year survival rate is about 22 percent.”

https://www.aacr.org/patients-caregivers/cancer/esophageal-cancer/

FDG PET CT of esophageal ca. The distal esophageal mass-like lesion is about 6 cm, with intense FDG activity, max SUV 24. There is no definite evidence for FDG-avid nodal metastasis. Note: brachy FDG activities in both lungs, most likely due to aspiration pneumonia.

National Comprehensive Cancer Network® (NCCN®) Comments on FDG PET/CT Imaging and Esophageal Cancer

“In esophageal cancer, patient survival is best correlated with the final pathologic stage, regardless of whether the patient has received preoperative therapy.10 Although surgical pathology yields the most accurate staging, advances in endoscopic techniques and imaging modalities such as endoscopic ultrasound (EUS), CT, and 18-fluorodeoxyglucose (FDG)-PET/CT have greatly improved the accuracy of clinical staging. In general, initial staging of locoregional disease is usually best done with a combination of CT and EUS, while staging of possible distant metastatic disease is best assessed with FDG-PET/CT.”

Source: https://www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf

Permission Pending from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Esophageal and Esophagogastric Junction Cancers Version 2.2023 — March 10, 2023. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed August 15, 2023 To view the most recent and complete version of the guideline, go online to NCCN.org.