Question Title: Benign tumor of the esophageal area.

My father had trouble swallowing on occasion for more than a year.
He had undergone a surgery for ligament damage that had invaded his
1-2 vertabre in the cervical area and was pressing on his spinal cord. This surgery was done when he
was eighty years old at the Allegheny General Hospital in Pittsburgh
Pa. and had to be done through his open mouth. My father is now 84. We contributed the swallowing problem to
be after effects of this surgery at first. But this year around
April 9th my father was eating some ramps which became lodged in his
throat and upon a rather uncomfortable night he let my sister take him to
the emergency room of the local VA hospital. Soon after this the
surgical residents supplied by the WVU program diagnosed him with
a 15cm tumor of the esophagas and removed a biopsy. The biopsy was
reported as negative. The doctor was not satisfied with a negative biopsy
so he performed a second biopsy with a deeper penetration of the tissue
which also came back negative. A third biopsy was performed through the wall of
the abnomen before a stomach tube was inserted for feeding purposes.
This also came back negative. He was then placed on a diet of ensure
for the remainder of near 30 days in the hospital before they
gave instructions to my sister on how to feed him through the
stomach tube and sent my father home. He followed up with the hospital
in early June and at that time he was told to return back on June 17th
upon which they would schedule him for surgery. He did return to
the hospital on that date only to be told the Surgical residents
were unavailable because they had departed for school vacation
between semesters. I decided I had, had enough because my father was
more than miserable by this time. I aranged a visit to another surgeon
who was a seasoned veteran and had an office in the physician office building
on the campus of the local non profit hospital. This surgeon saw him on tuesday
which was 6-23-98. After reviewing my fathers records that were retrieved
from the local VA hospital he listened to my fathers heart and then
scheduled him for a esophagram in the radiology department of the hospital
in which he practices. This test was to be on tuesday, June30th. Unfortunatly
my father passed away on friday June 26th from apparent heart failure
after 2 uncomfortable nights. My father always has had a good blood pressure
with no heart problems so I am convinced the tumor had every thing to
do with the heart failure because the tumor was located right behind
his heart. Can you offer me an understanding of what might have happened
to my father and if more could have been done quicker if I had taken him
somewhere other than a hospital that uses surgical residents from
a teaching university.

Thank You, Roger Wright
______
Dear Roger Wright,
Please accept my condolences on the passing of your father. The series of events that you describe are quite unusual. My first thought would be that your father had esophageal cancer and that the biopsiesd just missed the tumor. I admit that this explanation is weakened by the fact that multiple biopsies by different physicians did not demonstrate cancer. A second explanation is that your father had a benign tumor of the muscle of the esophagus. These tumors, which arer slow growing, can cause swallowing difficulties due to mechanical obstruction of the esophagus. The surgery to remove these tumors can be tricky, particularly in an elderly man. The third possibility is that your father had a tumor that originated outside the esophagus but that grew and impinged on the esophagus. This tumor could be benign or malignant and could arise from lung or heart. The negative biopsies would be explained by the fact that the tumor did not involve the lining of the esophagus, the site of the biopsies.

I hope that htis information is helpful to you.

HFHSM.D.-rf
*keywords: esophageal tumor, swallowing propblem
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