Esophageal carcinoma is a malignancy arising from the esophageal mucosa. There are 2 major histologic types: squamous cell carcinoma (SCC) and adenocarcinoma.

• SCC – Has a striking geographic distribution spanning from China to parts of Iran, central Asia, Afghanistan, Siberia, and Mongolia. Exists in the United States, where it is more common in individuals of African descent than those of Northern European descent and in males than females, and tends to affect people of lower socioeconomic status. Tends to arise in the cervical and thoracic portion of the esophagus. Risk factors include alcohol intake and cigarette smoking, with these factors acting synergistically to increase risk. The risk factors account for around 90% of SCC in the United States.
• Adenocarcinoma – There has been an increase in incidence, with this histologic phenotype accounting for 75% of all new esophageal carcinomas. More common in males of Northern European descent with a male-to-female ratio of 6:1. Arises within the dysplastic columnar epithelium of the distal esophagus, particularly at the gastroesophageal junction, with gastroesophageal reflux disease and Barrett esophagus being primary risk factors. 

Presenting symptoms include progressive dysphagia to solids progressing to liquids, odynophagia, and weight loss. Early disease may present with subtle nonspecific symptoms such as a sensation of food sticking in the esophagus or retrosternal discomfort. Early adenocarcinoma is typically diagnosed with screening for Barrett esophagus. Advanced disease is often present at the time of diagnosis. Metastatic spread may occur to the liver, lymph nodes, lungs, pleura, and bones.