Clinical features of oesophageal cancer

Most patients have a history of progressive, painless dysphagia for solid foods. Others present acutely because of food bolus obstruction. In late stages weight loss is often extreme; chest pain or hoarseness suggest mediastinal invasion. Fistulation between the oesophagus and the trachea or bronchial tree leads to coughing after swallowing, pneumonia and pleural effusion. Physical signs may be absent but even at initial presentation cachexia, cervical lymphadeno-pathy or other evidence of metastatic spread are common.

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