Endoscopic Ultrasound-Guided Fine Needle Aspiration for Smooth Benign Appearing Esophageal Stricture Due to Metastatic Breast Cancer

Metastatic breast cancer is an uncommon cause of esophageal stricture. We present an 80 year-old woman with past medical historyof locally advanced breast cancer who admitted for evaluation of dysphagia. Barium swallow (i.g. esophageal fluoroscopy) demonstratedmoderate irregular narrowing in the distal thoracic esophagus. Endoscopy revealed distal esophageal stricture with normalesophageal mucosa and computed tomography demonstrated thickened wall in the distal esophagus and the proximal stomach.Endoscopic biopsy of esophagus revealed no malignancy. Thus, we performed endoscopic ultrasound-guide fine needle aspiration(EUS-FNA) and cytological results were consistent with metastatic breast cancer. Diagnosis of malignant esophageal stricture dueto metastasis from other primary is often challenging and requires a high index of suspicion. EUS-FNA is an alternative diagnostictechnique in such cases when endoscopic biopsy fails to obtain adequate specimen.