Early-onset aggressive oesophageal carcinoma in Down's syndrome - a coincidence or a game of extra genes?

Patients with Down's syndrome exhibit a unique pattern for a number of malignant conditions but there is inconsistent data for the risk of oesophageal cancer. We present a case of early-onset aggressive oesophageal carcinoma in a young male patient diagnosed with Trisomy 21, who presented with complaints of progressive dysphagia, vomiting, voice change and weight loss. Barium swallow showed shouldering sign at distal oesophagus.