PMC3278770_01
Barium esophagogram demonstrating a bird-beaked appearance of the distal esophagus with marked dysmotility.
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F1
Barium swallow demonstrated a bird-beaked impairment at the lower esophageal sphincter, consistent with the diagnosis of achalasia (figure 1).
Surgical specimen following neoadjuvant therapy demonstrating marked fibrosis at the gastroesophageal junction. Pathology revealed negative margins and a T3N0 esophageal adenocarcinoma.
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F2
An Ivor-Lewis esophagectomy was performed six weeks after he completed his neoadjuvant therapy (figure 2.).