Pseudoachalasia From Gastric Cancer

A 59-year-old woman was referred from another hospital for esophageal balloon dilatation, with the impression of idiopathic achalasia. She developed progressive dysphagia of 3-month duration associated with weight loss of about 5 kg. She did not have abdominal pain, odynophagia, tarry stool, or hematemesis. Her previous medical history was unremarkable. She denied tobacco use or alcohol consumption. Physical examination centered on abdominal findings of mild tenderness at the epigastric area. There was no palpable lymphadenopathy. Laboratory examinations including hemogram and serum tumor markers (carcinoembryonic antigen, 2.65 ng/mL; CA19-9, 18.78 U/mL) were within normal limits.