Esophageal cancer complicated with azygos continuation of the inferior vena cava.

Neoadjuvant (preoperative) therapy and combined modality therapy have become focuses of interest in the effort to prolong survival and to reduce recurrence rates in patients with esophageal cancer. Staging of the tumor is a critical step in establishing which therapeutic option is appropriate. Once surgical management is advocated, adequate medical imaging is crucial in determining individual anatomical variations. In this communication we report a case of a patient with azygos continuation who underwent chemoradiotherapy with successful downstaging of tumor status from T3-4 to T0 and a nodal status from N1 to N0 as evaluated by medical imaging and who then proceeded to curative surgical resection. This case highlights the potential ability of radiological techniques to confirm both anatomical variations and responses to neoadjuvant therapy.