Case of the Week

T2 sagittal image (A) shows an expansile lesion in the upper one-third of the esophagus. T1 precontrast sagittal and axial images (B and C) and postcontrast fat-saturation sagittal image (D), demonstrate sharp enhancement after administration of IV contrast, with submucosal projection, and extension to the posterior wall of the adjacent trachea, with infiltration of the tracheal muscles and projection into the tracheal submucosa, in close contact with the inferior and posterior surface of the cricoid cartilage plate. DWI and ADC/map images show no restricted diffusion (E and F). A surgical fragment (G) shows a hemithyroidectomy with cervical esophagectomy and laryngectomy. Microscopically (40x) the neoplasm (H) consists of atypical glands that are surrounded by a stromal desmoplastic reaction. Some of the glands form small cubes with basophilic material inside. The same sample was stained with alcian blue (I).