Oesophageal Leukoplakia: A Rare Precancerous Condition

We report a case of a 62-year-old female with a history of alcohol overuse and reflux oesophagitis, who had presented with a acute drop in haemoglobin. Suspecting an upper GI bleed, an urgent oesophago-gastro-duodenoscopy (OGD) was performed, which revealed a normal examination aside from a patch of whitish, scally plaque in the lower oesophagus, later confirmed by biopsy to be oesophageal Leukoplakia with hyperkeratosis, lacking dysplasia. No oral or cutaneous lesions were identified. The patient received counseling on lifestyle modifications to mitigate risk factors. Oesophageal Leukoplakia (OL) is an uncommon benign condition, with potential malignant progression, of the oesophagus, marked by white mucosal plaques, observed during endoscopy. While Leukoplakia is more frequently seen in the oral cavity, its oesophageal presentation is rare, leading to potential diagnostic challenges. The precise aetiology of OL remains unclear, though risk factors include chronic mucosal irritation from smoking, excessive alcohol intake, and gastroesophageal reflux disease (GERD). Management primarily focuses on modifying lifestyle factors that contribute to mucosal irritation, underscoring the importance of addressing modifiable risk factors in preventing lesion progression. Although there are no established surveillance guidelines for endoscopic follow-up in cases of oesophageal leukoplakia, individualized risk stratification is essential. Endoscopic resection either mucosal resection or sub mucosal dissection should be reserved for lesions demonstrating dysplasia.