Editor's Note: The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
Background
A 73-year-old woman presents with dysphagia and unintentional weight loss totaling approximately 10-15 lb over 3 months. The dysphagia is mild to moderate, with the transient feeling that food gets "stuck" in her chest, which only happens with solids. She denies fever, chills, nausea, emesis, abdominal pain, diarrhea, hematochezia, or melena but reports increasing fatigue and weakness.
The patient's medical history is significant for hypertension controlled with beta-blockers, as well as gastroesophageal reflux disease (GERD), which is well controlled with proton pump inhibitors. Previous surgical history is relevant only for a hysterectomy performed in response to benign tumors. The family history is not significant. The patient reports a smoking history of one pack a day for 25 years; she quit 10 years ago. Alcohol intake is occasional, approximately two to three glasses of wine with dinner three times a week.
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Cite this: Dysphagia and Weight Loss in a 73-Year-Old Woman - Medscape - Oct 28, 2014.
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