PMC5895463_01
Endoscopic views of the gastroesophageal junction carcinoma. (A) Antegrade view demonstrating an ovular-spheroid mass occupying the majority of the distal esophageal lumen. (B) Retroflexed view revealing an ulcerated, infiltrative mass involving the gastric cardia.
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F1
On esophagogastroduodenoscopy (EGD), there was an obstructing tumor starting 3 cm proximal to the gastroesophageal junction (GEJ) that had infiltrated into the gastric cardia, as seen on antegrade and retroflexed views (Figure 1); forceps biopsies were positive for carcinoma.
Computed tomography findings of pseudocirrhosis. (A) Axial view demonstrating markedly lobular hepatic contour as well as infiltrative gastroesophageal junction tumor and hepatosplenic lesions concerning for metastases. (B) Coronal view demonstrating segmental atrophy of the left hepatic lobe, further suggestive of pseudocirrhosis.
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F2
Computed tomography demonstrated infiltrating GEJ carcinoma and hepatosplenic lesions concerning for metastases; in addition, the liver appeared segmentally atrophic and had a markedly lobular contour (Figure 2).
Endoscopic stenting of the gastroesophageal junction lesion using an Ultraflex nitinol 18 mm x 15 cm covered esophageal stent.
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F3
The patient underwent uneventful palliative endoscopic stenting of the GEJ with a self-expanding metallic stent and was referred to oncology for further care, which was to include carboplatin-based chemotherapy and possibly radiotherapy (Figure 3).