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Fig. 9. —Case 9: 55-year-old man with epigastric discomfort who underwent upper gastrointestinal radiography. Radiologist reported study as showing "gastroesophageal reflux and irregularity of the distal esophageal mucosa compatible with peptic esophagitis and a possible stricture. Reexamination of the esophagus after appropriate medical therapy with either endoscopy or esophagram is recommended." Fourteen months later, endoscopy revealed carcinoma of distal esophagus.