Subtle Dysphagia as an Initial Presentation of Hidden Malignancy: A Report of 2 Cases.
- Author:
Hyehoon CHOI
1
;
Hyun Sop CHOE
;
Joon Sung KIM
;
Bomi SUL
;
Bo Young HONG
;
Seong Hoon LIM
Author Information
1. Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. seonghoon@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Dysphagia;
Post-swallowing remnant;
Metastasis;
Cancer;
Initial presentation
- MeSH:
Aged;
Aging;
Atrophy;
Brain;
Deglutition;
Deglutition Disorders*;
Hand;
Humans;
Lung Neoplasms;
Magnetic Resonance Imaging;
Meals;
Middle Aged;
Neoplasm Metastasis;
Prostatic Neoplasms;
Sensation;
Skull;
Tongue
- From:
Journal of the Korean Dysphagia Society
2019;9(1):46-49
- CountryRepublic of Korea
- Language:English
-
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.
