Large mass in bottom of right esophagus in my mom

[momyde__0]

  A 65 yr old woman.  She came down with upper respiratory symptoms a few weeks ago, followed by severe intestinal virus which caused a great deal of vomiting and diahrhea, this was followed by more upper respiratory symptoms, including cough and chest pain...this progressed to a very severe illness with several days of high fever (102 - 104) for several days over the New Years holiday.  She tried to wait it out until docs reopened after the holiday but Sunday night, the 3rd ended up in ER with severe chest pain and difficulty breathing, high fever and feeling VERY bad.  They did a chest xray and at first thought it was normal, they gave her IV antibiotics and sent her home that evening with prescription for Biaxin and ibuprofen/tylenol for fever/pain, saying it was an infection...her WBC was elevated at 16,000.  She was to return to her own doctor in a few days.  A couple of days later the hospital nurse called and told her they were sorry they didn't admit her, something showed up on the chest x-ray when the
  radiologist read it...they said if they had noticed it then they would have admitted her...she was to see her doc in 2 days and they were to send the xrays to her doc...they wouldn't tell her what was wrong with the xray.  At the doctors office, they told her she had a bacterial infection in her bloodstream and that the biaxin should be effective at treating the infection.  The chest xray revealed a large mass at the bottom of the right esophagus...the notes on the xray report showed a great deal of concern because of this large mass.  She did have upper GI with barium, endoscopy, and colonoscopy about a year ago for abdomen and chest pain which revealed nothing and the cause was stated to be stress plus a small hiatal hernia.  So this mass must have occured since then.  The doctor said because of the severity of the infection, nothing more could be done until the infection was cleared.  She said there was a possibility the mass was caused from infection, and that perhaps it was the source of the bloodstream
  infection, although they didn't seem that hopeful that the answer would be that easy.  The plan is to finish the antibiotics (another week) and then in 2 weeks repeat the xray...if the mass is still present, they will schedule a CT scan to try to determine the cause of the mass.  The other abnormality in the bloodwork is that her sodium was at virtually 0, because she has been having severe sweats they said she obviously was losing too much through perspiration, especially on top of the recent gastrointestinal illness.  She is to stay quiet, try to do nothing that would make her perspire, etc until the next appointment, and she is to drastically increase her salt intake.  Her blood pressure (she does have hypertension which she takes meds for) was 185/90...they didn't seem too concerned about this as they said it probably related to the stress of this severe illness.  Does it seem possible such a mass could be caused from infection?  Does it seem appropriate to delay CT testing until the infection is clear?
  I am greatly concerned about my mother.  I just had a friend die of stomach cancer which progressed extremely rapidly and caused her death in a matter of weeks.  It seems to me if the mass is extremely large and wasn't there a few months ago, that would indicate it may be aggressive.  Please give me your opinion.  Thank you...I do appreciate your forum and the voluntary contributions of the doctors who freely give of their time to help us as we seek answers!
  mommydee
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Dear mommydee,
The tests that were done a year ago should have detected a mass if it was present.  From your posting it is difficult to discern the relationship between infection and mass.  There is no apparent reason why the CT scan must wait until the infection has cleared.  It can certainly be done now.  If there is a question of an esophageal mass, then an upper endoscopy is warranted.
This information is presented for educational purposes only.  Ask specific questions to your personal physician.
HFHSM.D.-rf
*keywords: esophageal mass
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