07 November 2025
: Case report 
Navigating Diagnostic Challenges in Pseudoachalasia: A Case Study of Esophagogastric Junction Adenocarcinoma
Unusual clinical course, Challenging differential diagnosis
Thanh Huu Nguyen
ABCDEF 1, Thang Quoc Le ABE 2, Muoi Xuan Nguyen ADE 1*, Ha Van Quoc BDE 1, Thinh Van Quoc Tran BDE 2, Pham Thi Thu Huong BCE 2, Ta Que Phuong BEF 1, Bui Chi Nam BEF 1, Pham Duc Huan ADE 3
DOI: 10.12659/AJCR.948966
Am J Case Rep 2025; 26:e948966
Table 1 Pseudoachalasia caused by adenocarcinoma cases with diagnostic challenges between 2010–2025* [6,7,17–19].
| Author (date of publication) | Sex/Age | Duration of symptoms | Investigation challenges | Treatment | Outcomes |
|---|---|---|---|---|---|
| Roushan et al (2014) []17 | 78/Male | 1 month | EGD and biopsy (−)Dx: Followed CT scan and EUS: Mass | Chemoradiotherapy | Passed away after 6 months |
| Jia et al (2015) []18 | 81/Male | 4 years | EGD, CT (−). Achalasia: a brief failure with dilationDx: EUS detects a mass after 6 months | Chemotherapy | N/A |
| Kajal et al (2023) []6 | 53/Female | Chronic dysphagia | EGD, biopsy (−). A failed POEM due to scarring.Dx: New pancreatic lesions → Using small cope to stomach and detect a mass | Chemotherapy | Passed away a few months later |
| Clive et al (2024) []7 | 65/Female | 4 months | Gastroesophageal reflux treatment without response for 4 months.Dx: CT and EGD | Surgery and chemotherapy | Recover for 1 year |
| Yu et al (2024) []19 | 49/Male | 1 month | EGD 2 times (−)Barium, CT: (−)Dx: POEM → biopsied → Adenocarcinoma | Surgery and chemotherapy | Died 4 months later |
| Our case (2025) | 62/Male | 2 years | EGD, CT, MRI, multiple biopsies, EUS (−), failure dilationDx: Followed CT scan after 6 months from the first EGD: Mass | Surgery and chemotherapy | Follow-up 6 months |
| * The search concentrated on PubMed with keywords: challenging diagnosis/misdiagnosis/delayed diagnosis, pseudoachalasia, adenocarcinoma, and case reports. Dx – diagnosis. | |||||