Clinical presentation

A 54-year-old woman, with a history of partial strumectomy due to hyperthyroidism, was referred for evaluation of chronic dysphagia for solids for more than 10 years. In the last few months, she was only fed on a liquid diet and lost approximately 6 kg in weight. Neither reflux symptoms nor thoracic pain were present. Physical examination and screening blood tests were unremarkable. Upper endoscopy (supplementary video, figure 1), oesophageal high-resolution manometry (figure 2 …