Which symptom profile is most indicative of a structural lesion such as cancer in dysphagia?

• A. Intermittent dysphagia to both solids and liquids with no weight loss
• B. Odynophagia only with spicy foods
• C. Progressive solid-dysphagia with weight loss
• D. Chronic cough without dysphagia

Answer: (C)

Dysphagia from a structural lesion—like cancer—tends to produce a narrowing of the esophagus that first blocks solids and then, as the obstruction grows, also impedes liquids. The combination of progressive difficulty with solid foods and weight loss is a classic red flag for a mechanical obstruction such as a tumor, because the obstruction gets worse over time and weight loss reflects decreased intake or disease burden. In contrast, motility problems often affect solids and liquids early and more diffusely, without a clear progression or with signs like intermittent symptoms. Odynophagia limited to spicy foods suggests irritation rather than a fixed blockage, and a chronic cough without dysphagia doesn’t point to a swallowing obstacle.