The 50-year-old patient, complained of progressive difficulty in swallowing for four months, having had only liquid intake at the time of our workup. There was no history of tuberculosis, hypertension, chronic obstructive pulmonary disease, diabetes, any other chronic ailment, or significant family history. Blood biochemistry, including liver and kidney functions, was within normal limits. Ultrasound of the patient's abdomen was normal. A barium swallow (Figure 1) revealed a filling defect in the mid-thoracic oesophagus with shouldering effect and a hold-up of barium proximal to it. The CECT of the thorax (Figure 2) showed circumferential thickening of the oesophagus from carina to a distance of 4.5-cm. Fat plane with trachea and aorta was maintained. The gastro-oesophageal junction was not involved. The CECT of the abdomen showed normal liver, spleen, pancreas, and kidneys. No free fluid or lymphadenopathy was seen. Upper gastrointestinal endoscopy detected an ulcero-nodular, friable, obstructive growth at 22-cm from the incisor teeth; a scope negotiation below it was not possible. A biopsy (Figure 3) of growth revealed poorly differentiated adenocarcinomas. Alpha fetoprotein and serum transferrin were also within normal limits (3.1 ng/ml and 322 mg/dl). The option of surgery was given, but the patient was not willing to have any surgical intervention. In view of the moderate nutritional status and a poor oral intake, a palliative external beam radiotherapy (EBRT) was given; as 20-Gy in five fractions over five days by AP/PA fields, using telecobalt, along with supportive treatment. Oral intake and general condition improved in the following four weeks and supplementary EBRT as 12-Gy in six fractions over one week was given. Supplementary intraluminal brachytherapy was offered in view of the good response to radiotherapy, but the patient refused. At third monthly follow-up, the patient was having an adequate semisolid and occasionally solid diet. Her general condition also improved, with no additional complaints.