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We focus on the difficulty to establish differential diagnosis only on the basis of routine exams and we stress the necessity of \u201csecond level\u201d instrumental exams; EUS in routine workup in selected patients should be considered. We support that routine workup based on history, clinical presentation, radiological and endoscopic findings, and certainly manometry could be insufficient for a correct differential diagnosis between primary and secondary forms in some patients.<\/jats:p>","DOI":"10.1155\/2014\/654917","type":"journal-article","created":{"date-parts":[[2014,7,15]],"date-time":"2014-07-15T21:07:23Z","timestamp":1405458443000},"page":"1-5","source":"Crossref","is-referenced-by-count":3,"title":["Achalasia Secondary to Submucosal Invasion by Poorly Differentiated Adenocarcinoma of the Cardia, Siewert II: Consideration on Preoperative Workup"],"prefix":"10.1155","volume":"2014","author":[{"given":"Antonino","family":"Agrusa","sequence":"first","affiliation":[{"name":"Dipartimento di Chirurgia Generale d\u2019Urgenza e dei Trapianti d\u2019Organo, U.O.C. 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