Cancer of the esophagus is not as prevalent in the United States as other tumors of the gastrointestinal tract. However, the overall mortality from this disease is extremely high. Esophageal cancer accounts for only about 7% of all tumors arising from the hollow viscera, with approximately 12,000 new cases reported in 2000 [1]. The 5-year survival rate is less than 10% [2].
The esophagus is lined by squamous epithelium, and therefore the prevalent histology of esophageal tumors is squamous cell carcinoma, accounting for approximately 85% of cases [3]. Barretts esophagus is a columnar metaplasia of the squamous epithelium of the esophagus likely related to gastroesophageal reflux disease. Barretts esophagus is considered a premalignant condition, predisposing patients to the development of adenocarcinoma of the esophagus [2, 4] (Figs. 1 and 2). Barretts esophagus increases the risk of developing adenocarcinoma by at least 30-fold over the general population, and there has been a significant increase in the incidence of adenocarcinoma arising in Barretts mucosa over the past few decades [2]. Other histo-logic types, such as sarcomas, occur but are extremely rare.
The greatest risk factors for the development of esophageal cancer are chronic abuse of tobacco and alcohol. Other conditions that may also predispose to the development of squamous cell malignancy of the esophagus include achalasia, lye strictures, celiac disease, Plummer-Vinson syndrome, and tylosis [2, 4], Patients with achalasia have a 30-fold greater likelihood of developing esophageal cancer than the general population [3] (Fig. 3).
This review outlines the imaging findings that may be encountered in the diagnosis, staging, and follow-up of esophageal carcinoma.