A history of smoking and/or alcoholism is often present in patients with esophageal squamous carcinoma, while a history of Barrett esophagus precedes development of esophageal adenocarcinoma in many cases. Above, an ill-defined mass at the gastroesophageal junction produces mucosal ulceration and irregularity, which led to the clinical symptoms of pain and difficulty swallowing. The mucosal irregularity is shown in the upper GI endoscopy view in the image below.