A 42-year-old woman presents with fatigue, glossitis, koilonychia, and difficulty swallowing solids. Endoscopy shows a web in the upper esophagus. Peripheral smear confirms microcytic hypochromic anemia. This patient is at increased risk for which malignancy?

• A Lymphoma of the small bowel
• B Adenocarcinoma of the gastric cardia
• C Squamous cell carcinoma of the esophagus ✓
• D Leiomyosarcoma of the esophagus

Explanation

The triad of iron deficiency anemia, glossitis, koilonychia, and an upper esophageal web defines Plummer-Vinson (Paterson-Kelly) syndrome. It is a recognized risk factor for squamous cell carcinoma of the esophagus, particularly in the postcricoid region. Adenocarcinoma of the cardia is linked to Barrett esophagus and obesity, not to webs. Recognition matters clinically because the dysphagia is correctable with iron therapy and dilatation, but surveillance for malignancy is warranted.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.