This case involves a fifty-six-year-old female patient who underwent treatment for difficulty swallowing both solids and liquids. The patient underwent several rounds of therapeutic dilations and barium swallows but was never fully worked to exclude malignancy as a cause of her issues. The patient was treated with conservative medical management for a number of years until her condition became worse as she lost a significant amount of weight over a short time period. The patient was eventually diagnosed with an adenocarcinoma of the esophagus that metastasized to her liver, lungs, and vertebral column. The patient died shortly after her diagnosis, as no surgical intervention was indicated due to advanced disease.
Question(s) For Expert Witness
- 1. What other tests should have been done to detect this condition?
Expert Witness Response E-000771
Cancer of the esophagus remains a devastating disease because it is usually not detected until it has progressed to an advanced, incurable stage. Modern imaging techniques, including barium esophagography, contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS), and positron-emission tomography (PET), are powerful tools in the detection, diagnosis, and staging of this malignancy. Barium esophagography has optimal sensitivity for the detection of lesions when a double-contrast technique is used.
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