LAUSR

We previously publish a case series of nonaneurysmatic dysphagia aortica in the elderly in this journal.1 Dysphagia aortica occurs because of extrinsic compression of the esophagus by the aorta. Diagnostic tools include chest radiography, esophagram, esophagogastroduodenoscopy (EGD) and computed tomography (CT). Here, we present an older patient suffering from lump sensation and his chest X ray revealed tortuous thoracic aortic and esophagram revealed persistent short segmental narrowing with smooth mucosal pattern at middle esophagus. The finally diagnosis is mediastinal mesothelioma by pleural biopsy under partial pleurectomy. A 69-year-old man presented to our otorhinolaryngology department complaining of lump sensation over esophagus and dysphagia for 20 days. Chest radiography and esophagram were arranged at outpatient department. Chest X ray revealed tortuous thoracic aortic and esophagram revealed suspicious for persistent short segmental narrowing with smooth mucosal pattern at middle esophagus at T7 level. EGD was arranged due to abnormal esophagram and showed narrowing of the upper esophageal lumen (28 cm, from oral incisor) due to external compression and the mucosa was normal (Fig. 1A). Esophageal compression by an aneurysm is the most common cause of dysphagia aortica and it is usually observed in the elderly, especially in hypertensive patient with cardiomyopathy. According to