CASE HISTORY

Patient has had difficulty in swallowing for 17 months, which has become more severe in the last 6 months. Regurgitation and pain in the sternum. Marked loss of weight and cachexia. A diagnosis of carcinoma of the oesophagus was made and Souttars tube was inserted. 4.5.39: gastrostomy performed. Following operation patient developed considerable respiratory distress with bubbling rales over both lungs.

PATHOLOGY

The specimen consists of the lower end of the oesophagus and cardiac end of the stomach. There is a  constricting, encircling growth with numerous warty, polypoid masses ulcerating the oesophageal mucosa. The growth has spread through the wall completely interrupting the muscle coats and has spread down on to both the great and lesser curves of the stomach. Situated on the lesser curve there are tow enlarged lymphatic lands invaded by tumour metastases.