A case of Plummer-Vinson syndrome complicated by early esophageal cancer diagnosed due to the presence of dysphagia

Abstract

Plummer-Vinson syndrome is a triad of iron deficiency anemia, glossitis, and dysphagia. We report the case of a 48-year-old woman who presented with dysphagia that had been slowly worsening for the past year. We suspected iron deficiency anemia because pallor of the eyelid conjunctiva and atrophy of the lingual papillae were observed in the initial examination. We also suspected esophageal dysphagia because of the patient's decreased laryngeal perception and preserved pharyngeal clearance, despite her worsening dysphagia. Based on the results of upper gastrointestinal endoscopy and esophagography, we diagnosed Plummer-Vinson syndrome with intraepithelial carcinoma of the lower esophagus. At two months after the initiation of iron therapy, her hemoglobin improved to baseline levels, her esophageal web disappeared, and her dysphagia improved. Endoscopic submucosal exfoliation was performed at 6 months after the start of treatment, and the pathological result was early-stage esophageal cancer. Because Plummer-Vinson syndrome is known to be associated with malignant tumors, regular follow-up should be conducted in collaboration with other departments, including endoscopy by a gastroenterologist, otorhinolaryngology, and head and neck surgery.