Cupola Effect

The cupola effect refers to oral barium forming a dome over a pedunculated esophageal tumor and flowing into the space between the tumor and the esophageal wall.

The cupola effect is one of the features of spindle cell carcinoma (carcinosarcoma) of the esophagus. Indeed, when a polypoid, pedunculated and bulky esophageal mass with a cupola effect has scalloped edges and expands the lumen of the esophagus, spindle cell carcinoma should be the primary diagnosis.

References

• McCort JJ. Esophageal carcinosarcoma and pesudosarcoma. Radiology. 1972 Mar;102(3):519-24.
• Olmsted WW, Lichtenstein JE, Hyams VJ. Polypoid epithelial malignancies of the esophagus. AJR Am J Roentgenol. 1983 May;140(5):921-5.