LAUSR

A 73-year-old male with complaints of dysphagia, fatigue and weight loss for the past one year underwent an upper gastrointestinal endoscopy, depicting a partially obstructing mass in the lower third of esophagus. An endoscopic ultrasound showed a hypoechoic mass with suggested invasion into the muscularis propria with two enlarged level 8 paraesophageal lymph nodes. By sonographic criteria, the tumor was staged as T3N1. Multiple biopsies confirmed poorly differentiated adenocarcinoma (cytokeratin positive) with gland formation (<50% of tumor) and with focal signet ring cells and some extracellular mucin (Figure 1A).