Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa
Abstract A 45‐year‐old man underwent esophagogastroduodenoscopy because of symptoms of laryngopharyngeal discomfort. We found a protruded reddish lesion adjacent to the ectopic gastric mucosa (EGM) in the cervical esophagus, and a biopsy revealed that it was a tubular adenocarcinoma. We diagnosed th...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | DEN Open |
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| Online Access: | https://doi.org/10.1002/deo2.141 |
| _version_ | 1797837260958203904 |
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| author | Ryosuke Ikeda Kingo Hirasawa Yuichiro Ozeki Atsushi Sawada Masafumi Nishio Takehide Fukuchi Chiko Sato Shin Maeda |
| author_facet | Ryosuke Ikeda Kingo Hirasawa Yuichiro Ozeki Atsushi Sawada Masafumi Nishio Takehide Fukuchi Chiko Sato Shin Maeda |
| author_sort | Ryosuke Ikeda |
| collection | DOAJ |
| description | Abstract A 45‐year‐old man underwent esophagogastroduodenoscopy because of symptoms of laryngopharyngeal discomfort. We found a protruded reddish lesion adjacent to the ectopic gastric mucosa (EGM) in the cervical esophagus, and a biopsy revealed that it was a tubular adenocarcinoma. We diagnosed the patient with intramucosal cancer and performed endoscopic submucosal dissection. Esophageal endoscopic submucosal dissection was performed under general anesthesia using a conventional procedure. The resected tumor measured 23 × 14 mm and was adjacent to the EGM. Histologically, the tumor cells showed moderately well‐differentiated adenocarcinoma confined to the muscularis mucosa with no lymphovascular infiltration. Immunohistochemically, the tumor cells were positive for intestinal markers, namely MUC2 and CD10, and negative for gastric markers, namely MUC5AC and MUC6. The patient had no post‐endoscopy submucosal dissection stenosis and remained disease‐free without local recurrence. EGM of the cervical esophagus develops from the columnar epithelium during embryonic development. There are few reports on endoscopic submucosal dissection for mucosal cancer. Of these, immunostaining was performed in three cases. All were positive for MUC5AC and MUC6 and negative for MUC2 and CD10. Usually, EGM shows gastric type epithelium, but occasional cases with intestinal metaplasia, which show positivity for MUC2 and CD10, have been reported. Therefore, we consider this to be an extremely rare case of esophageal adenocarcinoma arising from intestinal metaplasia within the EGM. |
| first_indexed | 2024-04-09T15:22:56Z |
| format | Article |
| id | doaj.art-bb72de53fb644c92b894da96c496a17a |
| institution | Directory Open Access Journal |
| issn | 2692-4609 |
| language | English |
| last_indexed | 2024-04-09T15:22:56Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj.art-bb72de53fb644c92b894da96c496a17a2023-04-29T05:12:58ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.141Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosaRyosuke Ikeda0Kingo Hirasawa1Yuichiro Ozeki2Atsushi Sawada3Masafumi Nishio4Takehide Fukuchi5Chiko Sato6Shin Maeda7Endoscopy Division Yokohama City University Medical Center Kanagawa JapanEndoscopy Division Yokohama City University Medical Center Kanagawa JapanEndoscopy Division Yokohama City University Medical Center Kanagawa JapanEndoscopy Division Yokohama City University Medical Center Kanagawa JapanEndoscopy Division Yokohama City University Medical Center Kanagawa JapanEndoscopy Division Yokohama City University Medical Center Kanagawa JapanEndoscopy Division Yokohama City University Medical Center Kanagawa JapanDepartment of Gastroenterology Yokohama City University Graduate School of Medicine Kanagawa JapanAbstract A 45‐year‐old man underwent esophagogastroduodenoscopy because of symptoms of laryngopharyngeal discomfort. We found a protruded reddish lesion adjacent to the ectopic gastric mucosa (EGM) in the cervical esophagus, and a biopsy revealed that it was a tubular adenocarcinoma. We diagnosed the patient with intramucosal cancer and performed endoscopic submucosal dissection. Esophageal endoscopic submucosal dissection was performed under general anesthesia using a conventional procedure. The resected tumor measured 23 × 14 mm and was adjacent to the EGM. Histologically, the tumor cells showed moderately well‐differentiated adenocarcinoma confined to the muscularis mucosa with no lymphovascular infiltration. Immunohistochemically, the tumor cells were positive for intestinal markers, namely MUC2 and CD10, and negative for gastric markers, namely MUC5AC and MUC6. The patient had no post‐endoscopy submucosal dissection stenosis and remained disease‐free without local recurrence. EGM of the cervical esophagus develops from the columnar epithelium during embryonic development. There are few reports on endoscopic submucosal dissection for mucosal cancer. Of these, immunostaining was performed in three cases. All were positive for MUC5AC and MUC6 and negative for MUC2 and CD10. Usually, EGM shows gastric type epithelium, but occasional cases with intestinal metaplasia, which show positivity for MUC2 and CD10, have been reported. Therefore, we consider this to be an extremely rare case of esophageal adenocarcinoma arising from intestinal metaplasia within the EGM.https://doi.org/10.1002/deo2.141cervical esophageal adenocarcinomaectopic gastric mucosaendoscopic submucosal dissectionintestinal metaplasiaintestinal‐type |
| spellingShingle | Ryosuke Ikeda Kingo Hirasawa Yuichiro Ozeki Atsushi Sawada Masafumi Nishio Takehide Fukuchi Chiko Sato Shin Maeda Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa DEN Open cervical esophageal adenocarcinoma ectopic gastric mucosa endoscopic submucosal dissection intestinal metaplasia intestinal‐type |
| title | Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa |
| title_full | Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa |
| title_fullStr | Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa |
| title_full_unstemmed | Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa |
| title_short | Cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa |
| title_sort | cervical esophageal adenocarcinoma of intestinal type in ectopic gastric mucosa |
| topic | cervical esophageal adenocarcinoma ectopic gastric mucosa endoscopic submucosal dissection intestinal metaplasia intestinal‐type |
| url | https://doi.org/10.1002/deo2.141 |
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