RESUMO
Esophageal adenocarcinoma develops when normal squamous epithelia are replaced by dysplastic intestinal columnar cells in response to chronic gastroesophageal reflux disease (GERD). In addition to squamous cell carcinoma, the two malignancies account for over 95% of esophageal malignancies. This case describes a sailor deployed onboard an aircraft carrier who initially presented with typical GERD symptoms and later developed multifactorial weight loss confounded by the operational environment. Upon return to homeport, he was diagnosed with stage III gastroesophageal junction adenocarcinoma. This case emphasizes the difficulty in identifying and diagnosing a rare and dangerous pathology in the resource-limited, operational environment.
Assuntos
Adenocarcinoma , Esôfago de Barrett , Neoplasias Esofágicas , Refluxo Gastroesofágico , Militares , Masculino , Humanos , Esôfago de Barrett/diagnóstico , Esôfago de Barrett/etiologia , Esôfago de Barrett/patologia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnósticoRESUMO
A 28-year-old woman with an unremarkable medical history presented with an enlarging nodule that had been growing under her left great toenail for 6 months. The patient monitored the nodule, hoping that it would resolve on its own, but found that it steadily increased in size and began to displace the nail, causing pain. At the time of presentation, the nodule measured approximately 10 mm in diameter, and there was significant (~80°) superior displacement of the nail.
