Question

A 66-year-old man presents with nausea and recurrent vomiting. His wife accompanies him and adds she thinks his voice has changed. His past medical history is significant for alcohol abuse, tobacco abuse, hypertension, COPD and celiac disease. During examination, his voice is raspy and hoarse. You order a chest and neck CT scan which reveals a mass. Which of the following is the most likely location of this mass?

A) Gastric cardia
B) Gastric pylorus
C) Lower one-third of the esophagus
D) Upper two-thirds of the esophagus

Answer 1

The most likely location for the mass based on the patient's symptoms of voice changes and the CT scan findings is the upper two-thirds of the esophagus (D), impacting the nearby laryngeal area and leading to hoarseness.

Step-by-step explanation:

Considering the symptoms presented by the patient, such as nausea, recurrent vomiting, a change in voice leading to a raspy and hoarse sound, and the findings of a mass from a chest and neck CT scan, the most likely location of this mass is in the region of the upper two-thirds of the esophagus (D). This area is responsible for transporting food from the mouth to the stomach and is situated posterior to the trachea, which is in proximity to the larynx where the vocal cords are located. Given the patient's symptoms of voice changes, it's plausible that the mass is impacting the laryngeal area, causing hoarseness.