Article
Singultus: an uncommon genesis
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Published: | July 6, 2010 |
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Outline
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Introduction: Singultus can be caused by many reasons. A temporary singultus is often without any pathological significance. Singultus because of a malignant origin is very unusual.
Methods: Case history and comparison with updated literature.
Case history: A 60 year old male patient introduced himself in our clinic with permanent persisting and excruciating singultus. No dysphagia was present while a lost weight about 5 kg was recognized during the last week. A following panendoscopy showed a high-grade suspicion of a malignant process in the middle part of the oesophagus. The taken biopsy showed an invasive, moderately differentiated adenocarcinoma of the oesophagus. The following staging resulted in an already metastatic stage. The patient died of multi-organ failure before the therapy started.
Conclusion: In literature only few cases are known where oesophagus or gastric cancer shows a persistent singultus as a symptom. Central and peripheral nervous system disorders as well as toxic or metabolic disorders should always be taken into consideration in cases where singultus is resistance to therapy. Uncommonly, as in our case, tumours of the oesophagus causes an irritation of the phrenic nerve. A quick diagnostic is enormously important in these cases to avoid such fulminant progresses.
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