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Post-Caustic SCC Risk — RACP Adult Medicine MCQ

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HardGastroenterology & HepatologyPost-Caustic SCC RiskRACP Adult Medicine

A 50-year-old man presents with a 2-month history of progressive dysphagia for solids and regurgitation. He has a history of corrosive oesophageal injury 20 years ago from an alkali ingestion. Endoscopy shows a long, tight oesophageal stricture. What is the late complication he is at increased risk for?

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Correct answer: A — Oesophageal perforation only

Corrosive (caustic) oesophageal injury, particularly from alkali ingestion, significantly increases the long-term risk of oesophageal squamous cell carcinoma (SCC). The risk increases 1000-fold and typically develops 15–40 years after the initial injury. The carcinoma usually develops at the site of stricture. Endoscopic surveillance is recommended beginning 15–20 years after the caustic injury. Barrett's oesophagus (and adenocarcinoma) is associated with GORD, not caustic injury.

Reference: eTG – 2025 – Gastrointestinal; ESGE – 2019 – Caustic Ingestion Guidelines