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We report a case of an esophageal ulcer that mimicked advanced esophageal cancer in a patient who was on alendronate sodium treatment. A 56-year-old woman presented with progressively worsening pain on swallowing. For the past 6 months she had been taking 5 mg/day alendronate sodium (Bonalon) for the treatment of postmenopausal osteoporosis. Upper gastrointestinal endoscopic examination revealed an ulcerative lesion in the lower esophagus that resembled an advanced esophageal cancer (Figure 1 ). The ulcers mucosa was normal, but the ulcer bed was uneven and would not stain with Lugol dye. Biopsy specimens of the ulcer bed showed a marked infiltration of neutrophils and eosinophils in the subepithelial space, but no signs of malignancy (Figure 2). We stopped the alendronate sodium and prescribed a proton-pump inhibitor. Endoscopic examination 2 months later showed marked improvement in the ulcer, with no esophageal stricture.

An esophageal ulcer mimicking advanced esophageal cancer in a patient on alendronate sodium treatment for osteoporosis