DOI: 10.36347/sjmcr.2016.v04i06.020

Pages: 428-429

Esophageal cancer most commonly presents with upper digestive symptoms such as dysphagia or vomiting. We report a case of 52-year-old man who sought medical attention for vague upper abdominal pain without dysphagia, left sided chest pain and high grade fever. On clinical evaluation and routine investigation with a chest X-Ray found to have left sided hydro-pneumothorax. On ICD insertion thick purulent fluid with food particles drained. On further evaluation, patient was diagnosed with carcinoma esophagus: squamous cell carcinoma with an esophageal-pleural fistula. Presentation of esophageal cancer directly as pyothorax without any preceding symptomatology is not an everyday phenomenon. This case reinforces the value of having an open mind in diagnoses, especially in context of unusual or non-specific symptomatology.