26th April 2024

A 58-year-old man, a heavy smoker and regular alcohol consumer, presents with a 6-month history of progressive difficulty swallowing, particularly solid foods, and a sensation of food ‘sticking’ in his throat.

A 58-year-old man, a heavy smoker and regular alcohol consumer, presents with a 6-month history of progressive difficulty swallowing, particularly solid foods, and a sensation of food ‘sticking’ in his throat. He also reports significant weight loss and occasional hoarseness. He denies any history of heartburn or acid reflux.

Investigations:

Haemoglobin: 110 g/L (130–180)

White cell count: 6.9 × 10^9/L (4.0–11.0)

Platelets: 230 × 10^9/L (150–400)

Barium swallow: Irregular narrowing of the lower oesophagus

Which is the most likely diagnosis?