Two cases of fundal gastric carcinoma producing a typical picture of achalasia, including a positive Mecholyl test, are described. The differential diagnosis of both conditions is discussed. Hypersensitivity to cholinergic agents should be interpreted only as representing anatomic and/or physiologic derangement of the myenteric plexus of the esophagus and should not be considered as pathognomonic of achalasia. Fundal carcinoma producing infiltrating lesions at the level of the myenteric plexus of the esophagus may closely simulate primary achalasia. The evaluation of achalasia in a given patient is not complete without careful radiologic and endoscopic studies with biopsy and cytologic sampling of any suspicious area.
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Herrera, A.F., Colon, J., Valdes-Dapena, A. et al. Achalasia or carcinoma? The significance of the mecholyl test. Digest Dis Sci 15, 1073–1081 (1970). https://doi.org/10.1007/BF02232871
- Public Health
- Differential Diagnosis
- Gastric Carcinoma