Esophageal Webs in a 59-Year-Old Female

An esophageal web is a thin mucosal fold that protrudes into the esophageal lumen and is covered with squamous epithelium. Most esophageal webs have been shown to occur anteriorly in the cervical esophagus. We present a unique case of a 59-year-old female with a history of left breast cancer status post chemo-radiation one year earlier now in remission who presented as a referral to the gastroenterology clinic for evaluation of 18 lbs unintentional weight loss in 2 months. Patient endorses mild dysphagia to solid food but denies night sweats, anorexia, palpitations, hematuria, hematemesis, and hematochezia. She is a current smoker with 8-pack years of smoking. Patient had a normal hemoglobin of 13.5 grams per deciliter (reference range, 12.0-15.5) but low mean corpuscular volume of 76 femtoliters (reference range, 77.8-94.0) with a normal anemia panel. Esophagogastroduodenoscopy (EGD) was significant for webs in the middle third esophageal region with the rest of the esophagus normal (Figure 1). Colonoscopy was normal. The diagnosis of esophageal web was made. The location of the esophageal web is unusual as most of them have been shown to occur anteriorly in the cervical esophagus. Patient was managed conservatively with significant improvement in her dysphagia and weight on follow up 3 months later.