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Case Report

J Korean Dysphagia Soc 2019; 9(1): 46-49

Published online January 30, 2019

Copyright © The Korean Dysphagia Society.

Subtle Dysphagia as an Initial Presentation of Hidden Malignancy: A Report of 2 Cases

Hyehoon Choi, M.D.1, Hyun-Sop Choe, M.D., Ph.D.2, Joon Sung Kim, M.D., Ph.D.1, Bomi Sul, M.D.1, Bo Young Hong, M.D., Ph.D.1, Seong Hoon Lim, M.D., Ph.D.1

Departments of 1Rehabilitation Medicine and 2Urology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

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.

Keywords: Dysphagia, Post-swallowing remnant, Metastasis, Cancer, Initial presentation

Article

Case Report

J Korean Dysphagia Soc 2019; 9(1): 46-49

Published online January 30, 2019

Copyright © The Korean Dysphagia Society.

Subtle Dysphagia as an Initial Presentation of Hidden Malignancy: A Report of 2 Cases

Hyehoon Choi, M.D.1, Hyun-Sop Choe, M.D., Ph.D.2, Joon Sung Kim, M.D., Ph.D.1, Bomi Sul, M.D.1, Bo Young Hong, M.D., Ph.D.1, Seong Hoon Lim, M.D., Ph.D.1

Departments of 1Rehabilitation Medicine and 2Urology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

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.

Keywords: Dysphagia, Post-swallowing remnant, Metastasis, Cancer, Initial presentation

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