Question

An elderly male patient presents with progressive dysphagia, particularly for solids, along with marked loss of weight. What is the most likely diagnosis?

• A. Achalasia cardia
• B. Carcinoma of oesophagus
• C. Reflux oesophagitis
• D. Stricture oesophagus

Hint:

Focus on how the dysphagia progressed — solids first — and what that pattern usually points to in an older patient.

Answer 1

The Correct Option is B

This question tests recognition of the classic presentation of oesophageal carcinoma from the pattern of dysphagia and weight loss.

1. Achalasia cardia: Unlikely — it causes dysphagia for solids and liquids together from the outset, with regurgitation, and is not typically associated with such marked weight loss.
2. Carcinoma of oesophagus: Correct — progressive dysphagia for solids first, in an elderly patient, with marked weight loss, is the textbook picture of an obstructing oesophageal tumour.
3. Reflux oesophagitis: Unlikely — the dominant symptom is heartburn, not progressive mechanical dysphagia with major weight loss.
4. Stricture oesophagus: A possible cause of dysphagia for solids, but a benign stricture does not usually produce the degree of weight loss described, and lacks the elderly-onset, progressive course pointing to malignancy.

Correct answer: Carcinoma of oesophagus.