Esophageal Tumors in Children

Esophageal tumors may be benign (not cancer) or malignant (cancer). Esophageal cancer is a disease in which malignant cells form in the tissues of the esophagus. The esophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. Most esophageal tumors in children begin in the thin, flat cells that line the esophagus.

Esophageal cancer may cause any of the following signs and symptoms. Check with your child’s doctor if your child has any of the following:

• Trouble swallowing.
• Streaks of blood in sputum (mucus coughed up from the lungs).
• Weight loss.
• Hoarseness and cough.
• Indigestion and heartburn.
• Vomiting with streaks of blood.

Other conditions that are not esophageal cancer may cause these same signs and symptoms.

Tests to diagnose and stage esophageal cancer may include the following:

• Physical exam and history.
• X-ray of the chest.
• CT scan.
• PET scan.
• Ultrasound.
• Biopsy.

Other tests used to diagnose esophageal cancer include the following:

Esophagoscopy: A procedure to look inside the esophagus to check for abnormal areas. An esophagoscope is inserted through the mouth or nose and down the throat into the esophagus. An esophagoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. A biopsy is usually done during an esophagoscopy. Sometimes a biopsy shows changes in the esophagus that are not cancer but may lead to cancer.

Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. Sometimes this procedure is used to remove part of the esophagus or lung.

Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of disease.

Treatment of esophageal cancer in children may include the following:

• Radiation therapy given through a plastic or metal tube placed through the mouth into the esophagus.
• Chemotherapy.
• Surgery to remove all or part of the tumor.

Treatment of recurrent esophageal cancer in children may include the following:

• A clinical trial that checks a sample of the patient's tumor for certain gene changes. The type of targeted therapy that will be given to the patient depends on the type of gene change.

Esophageal cancer is hard to cure because it usually is not possible to remove the whole tumor by surgery.