Surgery MCQ 84

Carcinoma of the esophagus shows variable occurrence along its length.

👉 Question:

Which site is least commonly affected by carcinoma of the esophagus?

A. Upper third

B. Middle third

C. Lower third

D. Esophago-gastric junction

✅ Correct Answer:

A. Upper third

📚 Expert Detailed Answer and Rationale:

A. ✅ The upper third of the esophagus is the least common site for esophageal carcinoma. Most tumors arise in the middle third (commonly squamous cell carcinoma) and lower third / esophagogastric junction (commonly adenocarcinoma).
B. Middle third ❌ – Squamous cell carcinoma most frequently occurs here.
C. Lower third ❌ – Adenocarcinoma is most common in this region, often associated with Barrett’s esophagus.
D. Esophago-gastric junction ❌ – Common site for adenocarcinoma of the distal esophagus.

🧠 High-Yield Points:

💡 Squamous cell carcinoma → usually affects middle third of the esophagus.
💡 Adenocarcinoma → usually affects lower third / esophagogastric junction, associated with GERD / Barrett’s esophagus.
💡 Upper third tumors are rare and usually squamous cell type.

📖 Read Related Topic:

🩺 Clinician’s Challenge:

Which histologic type is most commonly seen in the upper third of the esophagus?

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