Dr. Champlain Charest: A 50-year-old man was admitted to the Massachusetts General Hospital for the first time because of abnormal findings on serial x-ray films of the upper-gastrointestinal tract. He was in excellent health until three years before, when he first noted dysphagia. Soon afterward he had occasional fleeting, burning pains in the epigastrium, but the symptoms did not progress and the dysphagia was inconstant. His appetite remained excellent, and, although he had lost 23 lb (10.4 kg) over the previous three years, he regained 12 lb (5.5 kg) in two months after giving up smoking. He had no anemia, hematemesis, melena, vomiting, diarrhea, jaundice, pruritus, or weakness. An x-ray examination of the upper gastrointestinal tract done during hospitalization elsewhere one year ago, was said to show "shrinkage of the esophagus and a spot in the stomach." He was advised to return in two months but failed to do so.