, Volume 23, Issue 2, pp 122–126 | Cite as

Pseudoachalasia of the Cardia Secondary to Nongastrointestinal Neoplasia

  • Jose Luis Ulla
  • Estela Fernandez-Salgado
  • Victoria Alvarez
  • Alberto Ibañez
  • Santiago Soto
  • Daniel Carpio
  • Javier Vazquez-Sanluis
  • Luis Ledo
  • Enrique Vazquez-Astray
Original Article


A minor proportion of patients with achalasia eventually have a neoplasm and, as a consequence, pseudoachalasia is diagnosed. A neoplasm may either involve gastrointestinal junction or present a paraneoplastic effect. Over the global diagnoses of achalasia issued in 5 years of experience in our motility unit, we have found 13% (3/23 cases) of pseudoachalasia (2–4% in previous series, probably due to the fact that the population assisted was mainly composed of elderly patients). The origin of the neoplasm was bladder, prostate and metastases from epidermoid carcinoma of vocal chord. Treatment of primary neoplasm, besides classical approach (with dilatation of botulinum injection) may help in the resolution of this clinical disorder.


Pseudoachalasia Urologic neoplasm Paraneoplasic syndrome Deglutition Deglutition disorders 


  1. 1.
    Goldblum JR, Rice TW, Richter JE. Histopathologic features in esophagomyotomy specimens from patients with achalasia. Gastroenterology 1996;111(3):648–654.PubMedCrossRefGoogle Scholar
  2. 2.
    Raymond L, Lach B, Shamji FM. Inflammatory aetiology of primary esophageal achalasia: an immunohistochemical and ultrastructural study of Auerbach’s plexus. Histopathology 1999;35:445–453.PubMedCrossRefGoogle Scholar
  3. 3.
    Kahrilas PJ, Kishk SM, Helm JF, Dodds WJ, Harig JM, Hogan WJ. Comparison of pseudoachalasia and achalasia. Am J Med 1987;82:439–446.PubMedCrossRefGoogle Scholar
  4. 4.
    Moonka R, Patti MG, Feo CV, Arcerito M, De Pinto M, Horgan S, Pellegrini CA. Clinical presentation and evaluation of malignant pseudoachalasia. J Gastrointest Surg 1999;3(5):456–461.PubMedCrossRefGoogle Scholar
  5. 5.
    Rozman RW, Achkar E. Features distinguishing secondary achalasia from primary achalasia. Am J Gastroenterol 1990;85(10):1327–1330.PubMedGoogle Scholar
  6. 6.
    Liu W, Fackler W, Rice TW, Richter JE, Achkar E, Goldblum JR. The pathogenesis of pseudoachalasia: a clinicopathologic study of 13 cases of a rare entity. Am J Surg Pathol 2002;26(6):784–788.PubMedCrossRefGoogle Scholar
  7. 7.
    Gockel I, Eckardt VF, Schmitt T. Pseudoachalasia: a case series and analysis of the literature. Scand J Gastroenterol 2005;40:378–385.PubMedCrossRefGoogle Scholar
  8. 8.
    Kline MM. Successful treatment of vigorous achalasia associated with gastric lymphoma. Dig Dis Sci 1980;25:311–313.PubMedCrossRefGoogle Scholar
  9. 9.
    Colarian JH, Sekkarie M, Rao R. Pancreatic pseudocyst mimicking idiophathic achalasia. Am J Gastroenterol 1998;93:103–105.PubMedCrossRefGoogle Scholar
  10. 10.
    Clark SB, Rice TW, Tubbs RR, Richter JE, Goldblum JR. The nature of the myenteric infiltrate in achalasia: an immunohistochemical analysis. Am J Surg Pathol 2000;24:1153–1158.PubMedCrossRefGoogle Scholar
  11. 11.
    Parkman HP, Cohen S. Malignancy-induced secondary achalasia. Dysphagia 1994;9(2):292–296.PubMedGoogle Scholar
  12. 12.
    Robertson CS, Griffith CD, Atkinson M, Hardcastle JD. Pseudoachalasia of the cardia: a review. J R Soc Med 1988;81:399–402.PubMedGoogle Scholar
  13. 13.
    Ogilvie H. The early diagnosis of cancer of the esophagus and stomach. Br Med J 1947;2:405–407.CrossRefGoogle Scholar
  14. 14.
    Tracey JP, Traube M. Difficulties in the diagnosis of pseudoachalasia. Am J Gastroenterol 1994;89:2014–2018.PubMedGoogle Scholar
  15. 15.
    Vallera RA, Brazer SR. Botulinum toxin for suspected pseudoachalasia. Am J Gastroenterol 1995;90:1319–1321.PubMedGoogle Scholar
  16. 16.
    Poulin EC, Diamant NE, Kortan P, Seshadri PA, Schlachta CM, Mamazza J. Achalasia developing years after surgery for reflux disease: case reports, laparoscopic treatment, and review of achalasia syndromes following antireflux disease. J Gastrointest Surg 2000;4(6):626–631.PubMedCrossRefGoogle Scholar
  17. 17.
    Chinn JS, Schuffer MD. Paraneoplasic visceral neuropathy as a cause of severe gastrointestinal motor dysfunction. Gastroenterology 1988;95:1279–1286.PubMedGoogle Scholar
  18. 18.
    Chu G, Wilson PC, Carter CD, Lennon VA, Roberts-Thomson IC. Intestinal pseudo-obstruction, type 1 anti-neuronal nuclear antibodies and small cell carcinoma of the lung. J Gastroenterol Hepatol 1993;8:604–606.PubMedCrossRefGoogle Scholar
  19. 19.
    Condom E, Vidal A, Rota R, Craus F, Dalmau J, Ferrer I. Paraneoplastic intestinal pseudo-obstruction associated with high titres of hu autoantibodies. Virchows Arch A Pathol Anat Histopathol 1993;423:507–511.PubMedCrossRefGoogle Scholar
  20. 20.
    Lee HR, Lennon VA, Camilleri M. Paraneoplastic gastrointestinal motor dysfunction: clinical and laboratory characteristics. Am J Gastroenterol 2001;96:373–379.PubMedCrossRefGoogle Scholar
  21. 21.
    Lennon VA, Sas DF, Busk MF. Enteric neuronal autoantibodies in pseudoobstruction with small cell lung carcinoma. Gastroenterology 1991;100:127–142.Google Scholar
  22. 22.
    Lucchinetti CF, Kimmel DW, Lennon VA. Paraneoplastic and oncological profiles of patients seropositive for type 1 antineuronal nuclear autoantibodies. Neurology 1998;50:652–657.PubMedGoogle Scholar
  23. 23.
    Lamouliatte H, Zerbib F, Bernard PH, Quinton A. Pseudo-achalasia and cancer of the bladder. Ann Med Interne (Paris). 1993;144(4):303–304.Google Scholar
  24. 24.
    Eaves R, Lambert J, Rees J, King RW. Achalasia secondary to carcinoma of prostate. Dig Dis Sci 1983;28(3):278–284.PubMedCrossRefGoogle Scholar
  25. 25.
    Tucker HJ, Snape WJ, Cohen S. Achalasia secondary to carcinoma: manometric and clinical features. Ann Intern Med 1978;89:315–318.PubMedGoogle Scholar
  26. 26.
    Martinez C, Targarona EM, Sainz S, Cerdan G, Novell J, Trias M. Pseudoachalasia: a diagnosis to consider in the assessment of dysphagia. Gastroenterol Hepatol 2000;23:14–15.PubMedGoogle Scholar
  27. 27.
    Ziegler K, Sanft C, Friedrich M, Gregor M, Riecken EO. Endosonographic appearance of the esophagus in achalasia. Endoscopy 1990;22:1–4.PubMedGoogle Scholar
  28. 28.
    Carter M, Deckmann RC, Smith RC, Burrell MI, Traube M. Differentiation of achalasia from pseudoachalasia by computed tomography. Am J Gastoenterol 1997;92:624–628.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Jose Luis Ulla
    • 1
  • Estela Fernandez-Salgado
    • 1
  • Victoria Alvarez
    • 1
  • Alberto Ibañez
    • 1
  • Santiago Soto
    • 1
  • Daniel Carpio
    • 1
  • Javier Vazquez-Sanluis
    • 1
  • Luis Ledo
    • 1
  • Enrique Vazquez-Astray
    • 1
  1. 1.Digestive System ServicePontevedra Hospital ComplexPontevedraSpain

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