Which combination of signs would suggest a structural lesion such as cancer as the cause of dysphagia?

• A. Intermittent dysphagia to liquids only
• B. Progressive solid-dysphagia with weight loss
• C. Sudden chest pain
• D. Recurrent heartburn

Answer: (B)

A structural lesion like cancer tends to produce a pattern where swallowing becomes progressively more difficult for solids, and over time this can extend to liquids as the narrowing grows. The solid-food persistence and progression point to a fixed obstruction, and weight loss adds a systemic red flag that malignancy may be involved. So, this combination—dysphagia that starts with solids and worsens over time, accompanied by weight loss—best signals a structural cause such as cancer. By contrast, dysphagia to liquids only suggests a motility problem, sudden chest pain could indicate an acute event rather than cancer, and recurrent heartburn is more typical of reflux, not an obstructing lesion.