Achalasia Presenting as a Neck Mass

Excerpt

Achalasia of the esophagus is characterized by failure of relaxation of the lower esophageal sphincter, aperistalsis, and an increased sensitivity of the esophagus to cholinergic agents. Classical signs and symptoms of this disease include gradually progressive painless dysphagia; weight loss; and frequent regurgitation of previously ingested food, especially in the supine position. Furthermore, regurgitation with aspiration can cause wheezing, coughing, and choking, eventually progressing to chronic lung disease (1, 2). We report a patient with achalasia presenting as a changeable neck mass due to a markedly dilated cervical esophagus. This presentation has not been previously described.

An 87-year-old woman was