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Advanced Esophageal Squamous Cell Dysplasia and Early Carcinoma Detected After Remote Esophagectomy for Adenocarcinoma.

Shafa S, Madanick RD - ACG Case Rep J (2015)

Bottom Line: We present a case of squamous dysplasia and early squamous carcinoma of the esophagus after esophagectomy for esophageal adenocarcinoma.We briefly discuss mucosectomy and ablative therapy as potential treatment options.

View Article: PubMed Central - PubMed

Affiliation: Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC.

ABSTRACT
We present a case of squamous dysplasia and early squamous carcinoma of the esophagus after esophagectomy for esophageal adenocarcinoma. We briefly discuss mucosectomy and ablative therapy as potential treatment options.

No MeSH data available.


Related in: MedlinePlus

Initial endoscopy showing papillomatous nodularity at the esophagogastric anastomosis. (A) The papillomatous nodules are seen on the left posterolateral aspect of the esophagogastric anastomosis in antegrade views, with adjacent cobblestone appearance of the squamous mucosa of the distal remnant esophagus (acute and chronic reflux-type esophagitis). (B) The retroflexed view of the esophagogastric anastomosis from the gastric conduit revealed more significant extension of the papillomas.
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Figure 1: Initial endoscopy showing papillomatous nodularity at the esophagogastric anastomosis. (A) The papillomatous nodules are seen on the left posterolateral aspect of the esophagogastric anastomosis in antegrade views, with adjacent cobblestone appearance of the squamous mucosa of the distal remnant esophagus (acute and chronic reflux-type esophagitis). (B) The retroflexed view of the esophagogastric anastomosis from the gastric conduit revealed more significant extension of the papillomas.

Mentions: At the time of his first endoscopy in 2009, the esophagogastric anastomosis was seen 28 cm from the incisors, and at this site, cobblestone-appearing mucosa with raised nodularity was noted (Figure 1). Biopsies from the nodules came back as reactive atypia with papilloma-type changes. Given the patient's prior history of cancer with concern for recurrent cancer at this site, a repeat endoscopy with endoscopic ultrasound was performed, which only revealed patchy wall thickening in the esophagus, mainly involving the deep mucosa, with an overall thickness of 4.6 mm. The esophagogastric anastomosis was diffusely thickened (9.3 mm in total thickness), which was not concerning for a malignant invasion. A repeat sampling of this tissue only revealed reactive atypia with squamous papilloma changes. He subsequently underwent annual surveillance endoscopy by his community gastroenterologist.


Advanced Esophageal Squamous Cell Dysplasia and Early Carcinoma Detected After Remote Esophagectomy for Adenocarcinoma.

Shafa S, Madanick RD - ACG Case Rep J (2015)

Initial endoscopy showing papillomatous nodularity at the esophagogastric anastomosis. (A) The papillomatous nodules are seen on the left posterolateral aspect of the esophagogastric anastomosis in antegrade views, with adjacent cobblestone appearance of the squamous mucosa of the distal remnant esophagus (acute and chronic reflux-type esophagitis). (B) The retroflexed view of the esophagogastric anastomosis from the gastric conduit revealed more significant extension of the papillomas.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612751&req=5

Figure 1: Initial endoscopy showing papillomatous nodularity at the esophagogastric anastomosis. (A) The papillomatous nodules are seen on the left posterolateral aspect of the esophagogastric anastomosis in antegrade views, with adjacent cobblestone appearance of the squamous mucosa of the distal remnant esophagus (acute and chronic reflux-type esophagitis). (B) The retroflexed view of the esophagogastric anastomosis from the gastric conduit revealed more significant extension of the papillomas.
Mentions: At the time of his first endoscopy in 2009, the esophagogastric anastomosis was seen 28 cm from the incisors, and at this site, cobblestone-appearing mucosa with raised nodularity was noted (Figure 1). Biopsies from the nodules came back as reactive atypia with papilloma-type changes. Given the patient's prior history of cancer with concern for recurrent cancer at this site, a repeat endoscopy with endoscopic ultrasound was performed, which only revealed patchy wall thickening in the esophagus, mainly involving the deep mucosa, with an overall thickness of 4.6 mm. The esophagogastric anastomosis was diffusely thickened (9.3 mm in total thickness), which was not concerning for a malignant invasion. A repeat sampling of this tissue only revealed reactive atypia with squamous papilloma changes. He subsequently underwent annual surveillance endoscopy by his community gastroenterologist.

Bottom Line: We present a case of squamous dysplasia and early squamous carcinoma of the esophagus after esophagectomy for esophageal adenocarcinoma.We briefly discuss mucosectomy and ablative therapy as potential treatment options.

View Article: PubMed Central - PubMed

Affiliation: Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC.

ABSTRACT
We present a case of squamous dysplasia and early squamous carcinoma of the esophagus after esophagectomy for esophageal adenocarcinoma. We briefly discuss mucosectomy and ablative therapy as potential treatment options.

No MeSH data available.


Related in: MedlinePlus