Plummer-Vinson Syndrome and Esophageal Cancer in an Endoscopy Center of Dakar

Abstract

Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron deficiency anemia and a cervical esophageal web. It is one of the risk factors of the esophageal cancer. Objectives : To report the epidemiological, clinical, paraclinical and histological characteristics of patients with Plummer-Vinson syndrome associated with esophageal cancer. Patients and Methods: This was a retrospective study carried out at the digestive endoscopy center of Aristide le Dantec hospital in Dakar from January 2008 to December 2015. We included all patients with Plummer-Vinson syndrome associated with esophageal cancer. Results: We included 7 patients. The mean age was 36 years (24 - 65 years). There were 5 women and 2 men. The mean diagnostic period was 9 months (6 months - 15 years). The main clinical manifestations were dysphagia (100%), weight loss (100%) and clinical anemia (71.4%). The biology showed a mean hemoglobin level of 8.8 g/dl (6 - 11 g/dl), serum iron at 30.8 μg/dl (11 - 52 μg/dl) and ferritinemia at 6.2 ng/dl (1.5 - 25 ng/dl). The upper digestive endoscopy revealed a stenosis web of the cervical esophagus in all patients. An endoscopic dilatation was performed in all cases. After dilation, the endoscopy showed a tumor of the middle third of the esophagus in 4 cases and of the lower third in 3 cases. It was about of a squamous cell carcinoma in the tumors of middle third and of an adenocarcinoma in those of the lower third. Conclusion: At Aristide le Dantec hospital of Dakar, PVS is sometimes associated with an epidermoid carcinoma or an adenocarcinoma of the esophagus. The improvement of the prognosis depends on the early realization of an upper gastrointestinal endoscopy (UGI) in case of any dysphagia and the monitoring of the patients.