MALIGNANT PLEURAL MESOTHELIOMA PRESENTING AS ACHALASIA

A 65-year-old man with an occupational history of asbestos exposure de veloped dysphagia and vomiting. Clinical examinations at onset reveale d a dilated esophagus with smooth narrowing at the gastroesophageal ju nction and no apparent tumor in and around the esophagus. Achalasia wa s suspected. Dysphagia progressed gradually and examinations performed three months after the onset disclosed a tumor in the pleural and the peritoneal cavities. At laparotomy, the tumor extended from the pleur al cavity into the peritoneal cavity. Histological examination of the biopsied specimen demonstrated malignant mesothelioma. We report the f irst case of malignant pleural mesothelioma presenting as achalasia.