WHEREAS malignant transformation may occur in longstanding pharyngo-esophageal diverticula, this occurrence is relatively rare, with only 15 previously reported authenticated cases.1-16 Because of its rarity, and, more important, since grossly invasive carcinoma appears to be preceded by an in situ phase, the following case is reported.
Report of Case
Patient No. 54318 was first admitted to Beth Israel Hospital in early 1959 at age 76 when he underwent sigmoid colotomy and polypectomy for removal of a large adenomatous polyp. At this time, because of the complaint of dysphagia with heavy expectoration, a barium swallow was performed which disclosed a Zenker's pulsion diverticulum (Fig 1, Left).In ensuing years, he had the sensation of food "being caught and sticking in the throat" and experienced increasing difficulty in swallowing both food and saliva. Regurgitation of food occurred frequently. He refused operation, and on one occasion he developed an aspiration pneumonia.For