Name of the Condition

• Malignant neoplasm of lower third of esophagus
• Also known as esophageal cancer of the lower third or lower esophageal carcinoma.

Summary

• Malignant neoplasm of the lower third of the esophagus is a type of cancer located in the bottom section of the esophagus. It involves the abnormal growth of cells that spread and invade surrounding tissues and organs.

Causes

• The exact cause is not fully understood, but potential factors include chronic irritation of the esophagus, genetic mutations, and prolonged gastroesophageal reflux disease (GERD).

Risk Factors

• Age: More common in individuals over 50.
• Gender: Higher prevalence in males.
• Lifestyle: Tobacco use, excessive alcohol consumption.
• Medical conditions: Barrett’s esophagus, GERD, achalasia.
• Diet: Diet low in fruits and vegetables.

Symptoms

• Difficulty swallowing (dysphagia)
• Weight loss without trying
• Chest pain, pressure, or discomfort
• Persistent cough or hoarseness
• Vomiting

Diagnosis

• Endoscopy: Visualization and biopsy of the esophagus.
• Barium swallow X-ray: Imaging that highlights changes in the structure of the esophagus.
• CT scan or PET scan: For detailed images and to determine the cancer's spread.
• Endoscopic ultrasound: To evaluate the depth of tumor invasion and lymph node involvement.

Treatment Options

• Surgery: Esophagectomy to remove part of the esophagus.
• Radiation therapy: To kill cancer cells or shrink tumors.
• Chemotherapy: Drugs to attack cancer cells throughout the body.
• Targeted therapy: Focuses on specific abnormalities within cancer cells.
• Treatment choice depends on the cancer stage, patient health, and preferences.

Prognosis and Follow-Up

• Prognosis varies with stage at diagnosis; early-stage cancer has a better outcome.

• Regular follow-up appointments are crucial to monitor the response to treatment and check for recurrence.

  Complications

• Complications can include severe weight loss, nutritional deficiencies, recurrence of cancer, and spread to other parts of the body (metastasis).

Lifestyle & Prevention

• Dietary changes: Increase intake of fruits and vegetables.
• Smoking cessation and alcohol moderation: Reduce the risk.
• Regular monitoring: For individuals with Barrett's esophagus or chronic GERD, regular screening may help detect changes early.

When to Seek Professional Help

• Persistent difficulty swallowing, unexplained weight loss, or any prolonged, unexplained respiratory or gastrointestinal symptoms should prompt consultation with a healthcare provider.

Additional Resources

• American Cancer Society: https://www.cancer.org

• Esophageal Cancer Awareness Association: https://www.ecaware.org

  Tips for Medical Coders

• Verify the precise location of the neoplasm within the esophagus for accurate coding.
• Differentiate between malignant and benign neoplasms.
• Be attentive to coding guidelines that may change based on cancer staging or secondary sites.