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KMID : 1024320190090010046
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Journal of the Korean Dysphagia Society
2019 Volume.9 No. 1 p.46 ~ p.49
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Subtle Dysphagia as an Initial Presentation of Hidden Malignancy: A Report of 2 Cases
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Choi Hye-Hoon
Choe Hyun-Sop
Kim Joon-Sung
Sul Bo-Mi
Hong Bo-Young
Lim Seong-Hoon
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Abstract
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Subtle dysfphagia, which is increased post-swallowing remnants, is a frequent finding in the elderly with various etiologies. These changes in swallowing are frequently overlooked by physicians. On the other hand, subtle changes evident on a videofluoroscopic swallowing study (VFSS) may suggest hidden disease. Therefore, clinicians should evaluate incidental dysphagia. Case 1: A 65-year-old man with no relevant medical history, presented with dysphagia and residual sensation during meals. VFSS showed moderate post-swallowing remnants in the vallecular fossa and pyriformis sinus. Further examination revealed prostate cancer with multiple bone metastases including the skull. Case 2: A 60-year-old man complained of residual sensation after swallowing, which started 2 months ago. He had a history of lung cancer. Pharyngeal residue was observed on VFSS. A brain metastasis was observed on MRI. Post-swallowing residue is often neglected or overlooked by clinicians who regard them as the features of aging. The present cases show that mild dysphagia with increased post-swallowing remnants may be an initial presentation of a hidden malignancy with metastasis. Physicians should consider unexplained dysphagia or tongue atrophy as possible initial presentations of hidden malignancies.
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KEYWORD
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Dysphagia, Post-swallowing remnant, Metastasis, Cancer, Initial presentation
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