A 34-year-old woman has progressive dysphagia for solids, glossitis, and koilonychia. Hemoglobin is 8.5 g/dL with an MCV of 68 fL. Endoscopy reveals a web in the upper esophagus. This triad carries an increased risk of which malignancy?

• A Adenocarcinoma of the lower esophagus
• B Esophageal leiomyosarcoma
• C Gastric signet ring carcinoma
• D Squamous cell carcinoma of the upper esophagus ✓

Explanation

Plummer Vinson syndrome combines iron deficiency anemia, glossitis, koilonychia, and an upper esophageal web. It predisposes to squamous cell carcinoma of the esophagus and oral cavity, so patients require surveillance. Adenocarcinoma arises in Barrett metaplasia of the distal esophagus associated with GERD, not with iron deficiency webs, which eliminates option A.

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.