Dysphagia Lusoria due to diffuse idiophatic skeletal hyperostosis (DISH): Case Report

Abstract

Diffuse idiopathic skeletal hyperosteosis (DISH) (or Forestier’s Disease) is an ossifying diathesis characterized by spinel and peripheral enthesopathy. This disease is more prevalent in men, usually after the 5th decade of life. In this article, it is reported the case of a 78-year-old man presenting with progressive dysphagia, weight loss, malnutrition and dysphonia. Computed tomography showed an important bony prominence compressing the first portion of the esophagus, in the level of C3C4. The preferred treatment is the excision of the osteophyte. Correspondence to: Raul Ângelo Balbinot, Clinical Gastroenterology, Faculty of Medicine, Universidade de Caxias do Sul, Universidade de São Paulo, Brazil; E-mail: raulbalbinotti@terra.com.br Received: September 29, 2017; Accepted: October 30, 2017; Published: November 02, 2017 Introduction Diffuse idiopathic skeletal hyperosteosis (DISH) (or Forestier’s Disease) is an ossifying diathesis characterized by spinel and peripheral enthesopathy. It generally compromises the axial skeleton and in some cases the peripheral joints. This disease is more prevalent in men than women and the incidence increases with age – it is rarely seen before the 4th decade of life. It becomes symptomatic when the hyperosteosis involves the anterior margin of the cervical vertebrae, causing dysphonia, dyspnea and/or dysphagia. First described in 1950 by Forestier and Rotes-Querol [1] and reviewed in 1970 by Resnick et al. [2], the literature does not set a standard for the diagnosis or treatment of DISH. The purpose of this paper is to report a case of dysphagia lusoria due to DISH.