Case Report
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World J Gastrointest Endosc. May 16, 2011; 3(5): 101-104
Published online May 16, 2011. doi: 10.4253/wjge.v3.i5.101
Steakhouse syndrome causing large esophageal ulcer and stenosis
Shotaro Enomoto, Kazuyuki Nakazawa, Kazuki Ueda, Yoshiyuki Mori, Yoshimasa Maeda, Naoki Shingaki, Takao Maekita, Uki Ota, Masashi Oka, Masao Ichinose
Shotaro Enomoto, Kazuki Ueda, Yoshiyuki Mori, Yoshimasa Maeda, Naoki Shingaki, Takao Maekita, Masashi Oka, Masao Ichinose, Department of Gastroenterology, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-0012, Japan
Shotaro Enomoto, Kazuyuki Nakazawa, Department of Gastroenterology, Nishimurakai Koyo Hospital, 40 Tsuhada, Wakayama City, Wakayama 640-8315, Japan
Uki Ota, Ota Medical Clinic, 424-1 Ota, Wakayama City, 640-8323 Wakayama, Japan
Author contributions: Enomoto S and Nakazawa K contributed equally to this work; Enomoto S wrote the paper; Nakazawa K made preparations for this paper; Ueda K, Mori Y, Maeda Y and Ota U performed clinical endoscopy; Shingaki N and Maekita T analyzed data, Oka M and Ichinose M contributed to critical review of the article; All authors read and approved the final manuscript.
Correspondence to: Shotaro Enomoto, MD, PhD, Department of Gastroenterology, School of Medicine Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-0012, Japan. shoe@orion.ocn.ne.jp
Telephone: +8173-447-1335 Fax: +8173-445-3616
Received: December 21, 2010
Revised: April 22, 2011
Accepted: April 29, 2011
Published online: May 16, 2011
Abstract

A 66-year-old man developed dysphagia during dinner and was evaluated 2 d later in our hospital because of persistent symptoms. Upper gastrointestinal endoscopy showed no impacted food, but advanced esophageal cancer was suspected based on the presence in the upper esophagus of a large irregular ulcerative lesion with a thick white coating and stenosis. Further imaging studies were performed to evaluate for metastases, revealing circumferential esophageal wall thickening and findings suggestive of lung and mediastinal lymph node metastases. However, dysphagia symptoms and the esophageal ulcer improved after hospital admission, and histopathological examination of the esophageal mucosa revealed only nonspecific inflammation. At the time of symptom onset, the patient had been eating stewed beef tendon (Gyusuji nikomi in Japanese) without chewing well. Esophageal ulceration due to steakhouse syndrome was therefore diagnosed. The lung lesion was a primary lung cancer that was surgically resected. Although rare, steakhouse syndrome can cause large esophageal ulceration and stenosis, so care must be taken to distinguish this from esophageal cancer.

Keywords: Esophageal stenosis; Esophagus; Ulcer; Dysphagia; Steakhouse syndrome