Clinical Decision-Making in Peptic Esophageal Stenosis: To PEG or Not to PEG?

Esophageal strictures can cause dysphagia and malnutrition requiring enteral feeding. We report a 78-year-old woman with therapy-refractory distal esophageal stenosis initially considered benign. PEG tube placement for nutritional support revealed an unexpected squamous cell carcinoma. The patient underwent esophagectomy. We highlight diagnostic challenges and the need for careful PEG tube indication.