{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:56:07Z","timestamp":1776056167971,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>The progression from spinal cord injury(SCI) to secondary achalasia and subsequent esophageal squamous cell carcinoma (ESCC) is exceptionally rare. We report the case of a 51-year-old female who developed progressive dysphagia seven years after a T6-level spinal injury. Barium swallow and endoscopic examinations revealed the classic \u201cbird\u2019s beak sign\u201d and a suspicious esophageal lesion. Given the patient\u2019s paraplegic condition and associated anesthetic risks, endoscopic intervention was contraindicated. Following evaluation by a multidisciplinary team, a combined thoracoscopic-laparoscopic esophagectomy with cervical anastomosis, lymph node dissection, and pyloroplasty was performed. Postoperative pathology confirmed ESCC (pT2N0M0, Stage IIB). This case suggests a potential pathological sequence of \u201cSCI \u2192 achalasia \u2192 ESCC\u201d: SCI may induce or exacerbate achalasia through neurogenic mechanisms, while prolonged esophageal stasis likely elevates the risk of malignant transformation. Additionally, symptom masking due to paraplegia and procedural challenges often contribute to diagnostic delays, adversely affecting prognosis. This report highlights the need for individualized surveillance protocols and multidisciplinary intervention pathways in SCI patients with long-standing achalasia to improve clinical outcomes.<\/jats:p>","DOI":"10.3389\/fonc.2026.1764934","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:38:09Z","timestamp":1776055089000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Esophageal squamous cell carcinoma in a patient with spinal cord injury complicated by achalasia: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"YuHang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"XiaoMing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Guangyuan Central Hospital","place":["Guangyuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"B1","first-page":"E1","article-title":"Clinical guidelines for management of acute spinal cord injury","volume":"88","year":"2021","journal-title":"Neurosurgery"},{"key":"B2","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1097\/MCG.0000000000000780","article-title":"Etiology and pathogenesis of idiopathic achalasia","volume":"51","author":"Pressman","year":"2017","journal-title":"J Clin Gastroenterol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e14058","DOI":"10.1111\/nmo.14058","article-title":"Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0\u00a9","volume":"33","author":"Yadlapati","year":"2021","journal-title":"Neurogastroenterol Motil"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-019-01608-3","article-title":"Clinical impact of different cut-off values in high-resolution manometry systems on diagnosing esophageal motility disorders","volume":"54","author":"Kuribayashi","year":"2019","journal-title":"J Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/dote.12272","article-title":"Greatly increased prevalence of esophageal dysmotility observed in persons with spinal cord injury","volume":"28","author":"Radulovic","year":"2015","journal-title":"Dis Esophagus"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/dote\/dox072","article-title":"Esophageal achalasia: a risk factor for carcinoma. A systematic review and meta-analysis","volume":"30","author":"Tustumi","year":"2017","journal-title":"Dis Esophagus"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn311367-20230704-00299","article-title":"Multi-center retrospective study of achalasia in China","volume":"43","year":"2023","journal-title":"Chin J Dig"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jncc.2022.02.002","article-title":"Cancer incidence and mortality in China, 2016","volume":"2","author":"Zheng","year":"2022","journal-title":"J Natl Cancer Center"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002591","article-title":"Risk of esophageal cancer in achalasia: A matched cohort study using the nationwide veterans affairs achalasia cohort","volume":"119","author":"Low","year":"2024","journal-title":"Am J Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1111\/dote.12272","article-title":"Greatly increased prevalence of esophageal dysmotility observed in persons with spinal cord injury","volume":"28","author":"Radulovic","year":"2015","journal-title":"Dis Esophagus"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2019.113009","article-title":"Gastrointestinal dysfunction after spinal cord injury","volume":"320","author":"Holmes","year":"2019","journal-title":"Exp Neurol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-025-11895-y","article-title":"Long-term outcomes after per-oral endoscopic myotomy versus laparoscopic Heller myotomy in the treatment of achalasia: a systematic review and meta-analysis","volume":"39","author":"Ma","year":"2025","journal-title":"Surg Endosc"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.05.040","article-title":"POEM and GERD: prevalence, mechanisms, potential strategies for prevention, and management","volume":"20","author":"Ravi","year":"2022","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e70164","DOI":"10.1002\/deo2.70164","article-title":"Concurrent diagnosis of superficial esophageal cancer and esophageal achalasia: A case report and literature review","volume":"6","author":"Katsumi","year":"2025","journal-title":"DEN Open"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1764934\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:38:16Z","timestamp":1776055096000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1764934\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":14,"alternative-id":["10.3389\/fonc.2026.1764934"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1764934","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"1764934"}}