Snapshot A 60-year-old man who is an alchoholic complains of difficulty swallowing solids that has progressed to difficulty swallowing liquids. He has smoked 2 packs of cigarettes per day for the past 35 years. In addition he has progressive weight loss and weakness. Introduction Squamous cell carcinomas account for 95% of esophageal cancers Risk factors include smoking, alchohol, lye strictures, Plummer-Vinson Syndrome, diverticular disease, nitrosamines, and achalasia Most commonly located in the mid esophagus Spread locally through lymphatics Presentation Often presents with difficulty swallowing solids that progresses to liquids and lymphadenopathy Management 50% of esophageal cancers are resectable at the time of diagnosis Diagnostic tests FNA mucosal biopsy with endoscopy Treatment esophagectomy followed by radiation and chemotherapy Prognosis, Prevention, and Complications 5% five year survival rate Distant metastasis is to the liver (70%), lungs (60%), AND adrenal glands (35%)