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Clinical Challenges
August 1998

Radiological vs Endoscopic Evaluation of the Esophagus: Searching for a Second Primary Tumor

Author Affiliations


Arch Otolaryngol Head Neck Surg. 1998;124(8):932-933. doi:10.1001/archotol.124.8.932

I appreciate the opportunity to comment on the article by Agrawal and Wenig addressing the relative merits of radiological vs endoscopic evaluation of the esophagus in search for a simultaneous second primary tumor in patients with head and neck cancer. While dynamic imaging using contrast material does provide a substantial amount of information relative to esophageal function as well as variations in anatomy, this study is less helpful than direct visualization when searching for the second primary tumor. As a rule, swallowing disorders are best evaluated using cineoesophagraphy and/or esophagography and mucosal lesions are best evaluated using the endoscope.