Anterior cervical osteophyte-related dysphagia in a long-term growth hormone user: a case report.

BACKGROUND

Anterior cervical osteophytes can compress the esophagus, producing dysphagia. Although common on imaging in older adults, symptomatic osteophytic dysphagia is underdiagnosed, and the role of systemic anabolic factors in osteophyte growth is poorly characterized.

CASE DESCRIPTION: A 62-year-old male ex-military recreational bodybuilder presented with cervicalgia and left shoulder pain. Cervical radiographs and MRI demonstrated multilevel degenerative changes including a prominent anterior osteophyte at C3-C4 with esophageal compression. On directed questioning, he reported intermittent dysphagia with larger food boluses. He reported a cervical injury during jiu-jitsu training in 2001-2002 and disclosed approximately 20 years of patient-reported exogenous growth hormone (GH) and GH secretagogue use, including cyclical somatropin, sermorelin/GHRP-6 combination therapy, and ongoing nightly somatropin. No objective swallowing evaluation was performed given the mild, intermittent nature of symptoms.

CONCLUSION

This case raises the hypothesis that chronic GH axis stimulation, in combination with remote cervical trauma, may contribute to clinically significant osteophyte formation. Conservative management was initiated with dietary modification and counseling regarding GH cessation. Clinicians should screen for dysphagia in patients with cervical spondylosis and inquire about anabolic substance use as a potentially relevant history.