Martins MCL, Miyazaki DL, Gabiatti CCT, et al. - As nearly 4% to 10% of patients diagnosed with Chagas-induced megaesophagus disease develop esophageal carcinoma, researchers here sought to determine the natural history and clinical pattern of this entity. Among 593 patients with esophageal carcinoma who underwent treatment at a single Brazilian institution, they identified 32 patients with Chagas disease, of whom 11 had megaesophagus. Although the three groups were similar in terms of baseline characteristics, at presentation patients with Chagas megaesophagus–associated carcinoma (CMAC) had a lower rate of smoking. Outcomes emphasize promptly detecting CMAC, as it has a dismal prognosis. This strengthens the necessity for a high index of suspicion of esophageal carcinoma for patients with Chagasic megaesophagus.