Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery

Malignant disease of the esophagus is rarely seen early,

because of the absence, or mildness, of the symptoms. Dysphagia, the

one common symptom of all esophageal disease, is often ignored by the

patient until it becomes so marked as to prevent the taking of solid

food; therefore, the onset may have the similitude of abruptness. Any

well masticated solid food can be swallowed through a lumen 5

millimeters in diameter. The inability to maintain the nutrition is

evidenced by loss of weight and the rapid development of cachexia.

When the stenosis becomes so severe that the fluid intake is limited,

rapid decline occurs from water starvation. Pain is usually a late

symptom of the disease. It may be of an aching character and referred

to the vertebral region or to the neck; or it may only accompany the

act of swallowing. Blood-streaked, regurgitated material, and the

presence of odor, are late manifestations of ulceration and secondary

infection. In some cases, constant oozing of blood from the ulcerated

area adds greatly to the cachexia. If the recurrent laryngeal nerves

are involved, unilateral or bilateral paralysis of the larynx may

complicate the symptoms by cough, dyspnea, aphonia, and possibly

septic pneumonia.