All Sample Questions

Esophageal Cancer 2

Question

Vignette:

A 23-year-old female presents to the clinic with complaints of difficulty in swallowing (dysphagia) and intermittent hoarseness of voice. She also reports unintentional weight loss over the last few months. She has no past medical history and does not smoke or consume alcohol. A barium swallow test is performed and reveals an esophageal mass, which is later confirmed as esophageal cancer by biopsy. The mass is identified in the middle third of the esophagus. Which of the following arteries is most likely to be compressed by this mass?

Choices

A) Bronchial artery

B) Inferior thyroid artery

C) Left gastric artery

D) Aorta

E) Thoracic part of the descending aorta

Answer

B) Inferior thyroid artery

Explanation

The esophagus is divided into three parts: cervical, thoracic, and abdominal. The middle third of the esophagus is in the thoracic region, which is supplied by the bronchial, esophageal branches of the aorta, and inferior thyroid arteries. Given the location of the mass in the middle third of the esophagus, it's most likely compressing the inferior thyroid artery. This artery is the primary arterial supply to the middle and lower portion of the esophagus. The bronchial artery (Choice A) primarily supplies the bronchi and connective tissue of the lungs. The left gastric artery (Choice C) and the aorta (Choices D and E) are located too inferiorly to be affected by a mass in the middle third of the esophagus.