CARCINOMA IN A LONGSTANDING ZENKERS DIVER TICULUM

The authors report a case of carcinoma arising in a longstanding Zenke r's diverticulum, in a 66 years old man that refused surgical treatmen t for 25 years. Three months prior to his admission to our hospital, a n exacerbation of his dysphagia, which became severe, was observed; an d so was regurgitation, with passage to the airway during swallowing o r when asleep. The esophagram showed the diverticulum without images s ugestive of neoplasm, and with spilling of barium into the tracheobron chial tree. Esophagoscopy was refused by the patient. After surgical d iverticulectomy, a thickened area in the inferior portion of the diver ticular body was observed, which was histologically reported as a squa mous cell carcinoma with pearl formation, involving only the diverticu lar wall. Complementary radiotherapy with TCT was administered over th e esophagus, mediastinum and supraclavicular lymphatic areas, with a t otal dose of 5000 Cgy. Concomitant chemotherapy with Mitomycin and 5-F luorouracil was administered. After a 2 year follow-up, the patient is completely asymptomatic. We discuss etiopathogenic factors, clinical manifestations, diagnostic procedures, and therapeutic possibilities.