CTICasesDistal Esophageal Adenocarcinoma Presenting as a Subtle Retrocardiac Opacity
Imaging findings
A baseline lateral chest radiograph in a patient with new chest pain and dysphagia appears unremarkable in the retrocardiac region, but a radiograph obtained only three months later shows a new, subtle abnormality projecting into the retrocardiac/esophageal recess. CT performed the following day confirms a mass in the distal esophagus.
Key takeaways
A distal esophageal adenocarcinoma can become radiographically apparent within just a few months, so new or evolving retrocardiac opacity on serial radiographs -- especially with new dysphagia -- warrants close attention to the esophageal recess rather than being dismissed as a normal variant.
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