A CASE OF DYSPHAGIA CAUSED BY TWO SYNCHRONOUS DISTINCT ESOPHAGEAL MALIGNANCIES 76Panetta, James D., D.O.; Johnson, David A., M.D.*; Hayden, Carl T, VAMC; Arizona, PhoenixAmerican Journal of Gastroenterology: October 2004 - Volume 99 - Issue 10 - p S26 Abstracts Submitted for the 69th Annual Scientific Meeting of the American College of Gastroenterology: October 29–November 3, 2004, Orlando, Florida: ESOPHAGUS Free A 76 year man was referred by his primary care physician with a 2 week history of dysphagia. A barium swallow revealed an irregular narrowed lesion in the distal esophagus 5 cm in length. His past medical history was unremarkable, though he did complain of frequent reflux symptoms. He also has a history of heavy tobacco and alcohol use. He underwent EGD which revealed a 3 cm plaque-like tumor in the proximal esophagus (at 26 cm), and a 5 cm circumferential, partially obstructing mass in the distal esophagus (at 35 cm). Biopsies were taken. Biopsies from the proximal lesion revealed a poorly differentiated mucinous adenocarcinoma, whereas those from the distal lesion revealed a poorly differentiated squamous cell carcinoma. Images and a discussion of this case will be presented.© The American College of Gastroenterology 2004. All Rights Reserved.