Malignant tumours of the oesophagus usually develop from the mucous membrane. The upper part of the oesophagus contains squamous epithelial tissue, while the lower part can also contain glandular tissue. Accordingly, cancer of the oesophagus can also be made up of squamous epithelium (squamous cell carcinoma) or glandular tissue (adenocarcinoma).

Malignant tumours of the oesophagus are a relatively rare tumour disease with a total of 10 cases per 100,000 inhabitants per year. The disease occurs 3-4 times more frequently in men than in women.

Adenocarcinoma typically occurs in the lower third of the oesophagus. Carcinomas of the oesophagus with a different structure are rare. In recent years, there has been a noticeable increase in the frequency of adenocarcinomas in the lower third of the oesophagus, which are now more common there than squamous cell carcinomas.

The average age of onset for squamous cell carcinomas is around 55 years and around 63 years for adenocarcinomas.

Smoking and drinking, especially high-proof alcohol, are considered to be the most important risk factors for squamous cell carcinoma of the oesophagus. A multiplication of the risks has been demonstrated in the case of simultaneous high consumption of both cigarettes and alcohol. Nitrosamines (e.g. in cured food) or scar stenosis after alkali burns also increase the risk of developing the disease.

For adenocarcinoma, the presence of gastro-oesophageal reflux disease (chronic heartburn), which can lead to a particular transformation of the mucous membrane in the lower oesophagus (formation of a Barrett's oesophagus with the so-called Barrett's mucous membrane), is central. Barrett's oesophagus is considered a predisposing disease for adenocarcinoma of the oesophagus. In patients with Barrett's oesophagus, the risk of developing adenocarcinoma of the oesophagus can be estimated based on the cell changes. However, it should be noted that only a small proportion of people with gastro-oesophageal reflux disease develop oesophageal carcinoma (less than 0.01%). (>> Reflux outpatient clinic)

Symptoms are usually uncharacteristic and appear late. The main symptom of difficulty swallowing (dysphagia) only occurs when approx. 2/3 of the inner diameter of the oesophagus has been displaced. Other symptoms include weight loss, pain behind the breastbone and in the back as well as pneumonia (aspiration pneumonia), when food particles can enter the lungs in the presence of tumour-related connections between the trachea and oesophagus (oesophageo-tracheal fistulas).

Depending on the location and structure of the tumour (adenocarcinoma or squamous cell carcinoma), metastases can occur in lymph nodes and other organs.

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