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Oesophageal Cancer — RACP Adult Medicine MCQ

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EasyGastroenterologyOesophageal CancerRACP Adult Medicine

A 72-year-old man with a history of Barrett oesophagus presents with progressive dysphagia to solids over 3 months and 8 kg weight loss. Upper endoscopy shows an irregular, ulcerated mass at the gastro-oesophageal junction. Biopsy shows adenocarcinoma. What is the most likely diagnosis?

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Correct answer: A — Oesophageal carcinoma

Progressive solid dysphagia with weight loss and an ulcerated mass on endoscopy in a patient with Barrett oesophagus is oesophageal adenocarcinoma. Barrett oesophagus is the major risk factor for GOJ adenocarcinoma. Staging with CT and PET-CT determines resectability. Treatment for localised disease is neoadjuvant chemoradiation followed by oesophagectomy.

Reference: Cancer Council Australia – 2024 – Upper GI Cancer Guidelines