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Oesophageal SCC Dysphagia — RACP Adult Medicine MCQ

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EasyGastroenterologyOesophageal SCC DysphagiaRACP Adult Medicine

A 65-year-old man presents with progressive dysphagia for solids then liquids over 6 months, weight loss 10 kg, and regurgitation of undigested food. He has a palpable left supraclavicular lymph node (Virchow node). OGD shows a circumferential oesophageal mass at 30 cm. Biopsy shows squamous cell carcinoma. What is the most likely type of dysphagia?

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Correct answer: D — Mechanical/obstructive dysphagia (malignant)

Progressive dysphagia for solids (then liquids as tumour enlarges), weight loss, and Virchow node (left supraclavicular — suggests abdominal malignancy with thoracic duct spread) with OGD showing oesophageal SCC is malignant mechanical dysphagia. Staging CT and PET-CT are required. Treatment depends on stage: curative intent (neoadjuvant chemoradiation + surgery) vs palliative (oesophageal stenting, palliative radiotherapy).

Reference: Cancer Council Australia – 2024 – Oesophageal Cancer; eTG GI 2024