Caustic cicatrization of the pharynx associated with dysphagia and premalignant mucosal changes

Although esophageal strictures with attendant malignant degeneration are well known sequelae of caustic ingestion, fixed pharyngeal structural lesions and development of oral leukoplakia are not well appreciated consequences of such ingestion. We present a patient 12 yr after lye ingestion who displayed rapidly progressive dysphagia suggestive of esophageal carcinoma. Instead, adhesions bisecting the cricopharyngeal inlet and an upper esophageal stricture were found endoscopically. In addition, an area of hypopharyngeal leukoplakia with marked acanthosis, parakeratosis, and dysplasia was noted and resected. The management of this patient's dysphagia and subsequent follow-up for his potentially precancerous oral lesion form the basis of this report.