Yikes. spikes! Exposed tracheal cartilaginous spikes at EGD from malignant tracheoesophageal fistula

摘要

A 67-year-old woman with squamous cell carcinoma of the lung that had been diagnosed 6 months earlier, and recent biopsy-proven metastasis to her right hip, presented with 3 months of progressive dysphagia and involuntary weight loss. Physical examination revealed temporal "wasting, clear lung fields, a normal abdomen, and brown stool without occult blood. The results of all laboratory studies were normal except for a hemoglobin of 8.7 g/dL, microcytic indices, and a serum albumin level of 3-4 g/dL. Videoesophagography revealed barium spilling rapidly into the left main bronchus.