Which of the following conditions are associated with the development of esophageal carcinoma?

a.Caustic esophageal stricture

b.Achalasia of the esophagus

c.Plummer-Vinson syndrome

d.Esophageal diverticula

Chronic irritation of the esophageal mucosa by a variety of noxious stimuli (alcohol, tobacco, hot foods and liquids) eventually may lead to the development of esophageal carcinoma. A variety of other esophageal lesions have a recognized premalignant nature. The patient who survives the initial injury long enough to develop a caustic esophageal stricture has a 1000-fold increased risk of developing carcinoma compared with the normal population. Ten to 12% of patients with achalasia of the esophagus who are observed 15 years or more develop esophageal carcinoma. This is thought to be related to the irritating effects of the fermenting intraesophageal contents on the adjacent esophageal mucosa. Plummer-Vinson syndrome is a premalignant esophageal condition. Patients with this syndrome are typically elderly women who have cervical dysphasia and iron deficiency anemia. About 10% of patients will develop squamous cell carcinoma of the hypopharynx, oral cavity or esophagus. Finally, there have been isolated reports of esophageal carcinomas found incidentally within esophageal diverticula, presumably as the result of the irritating effects on the mucosa of stagnant, putrefying food within the pouch. Esophageal diverticula are therefore regarded as premalignant esophageal lesions although this occurrence is extremely rare.