Breast Carcinoma as a Cause of Dysphagia

A case is presented of a 74-year-old woman who had carcinoma of the breast metastatic to the mid-thoracic esophagus 19 years after radical mastectomy. Symptoms of prolonged intermittent dysphagia over a fiveyear period led to esophagoscopy, during which iatrogenic perforation occurred in the mid-esophagus without visualizing obstruction or tumor. Emergency thoracic esophagectomy and esophagogastrostomy with pyloroplasty resulted in a successful outcome. The case represents the longest interval to be reported between removal of a primary tumor and the appearance of a solitary metastasis in the esophagus.