Abstract
BackgroundBarrett's esophagus (BE) is characterized by presence of columnar epithelium in the lower esophageal mucosa, which originally comprises stratified squamous epithelium. Gastroesophageal reflux disease causes BE and BE adenocarcinoma (BEAC); further, the incidence of BEAC is increasing, especially in developed countries. Long-segment BE (LSBE) has a particularly high carcinogenic potential and necessitates treatment, surveillance, and prevention.Case presentationHerein, we report three cases of BEAC originating from LSBE larger than 15 cm. All three patients underwent surgery for the diagnosis of BEAC. A 66-year-old man with advanced esophageal cancer underwent neoadjuvant chemotherapy and subsequent subtotal esophagectomy. The postoperative pathological diagnosis was of poorly differentiated adenocarcinoma with lymph node metastasis (pT3 pN3 pM0 pStage III based on the Union for International Cancer Control TNM Classification 8th edition). Two years after the operation, the patient was diagnosed with recurrence around the celiac artery and underwent chemotherapy. An 83-year-old woman with advanced esophageal cancer underwent subtotal esophagectomy. The postoperative pathological diagnosis was of well-differentiated adenocarcinoma with supraclavicular lymph node metastasis (pT3 pN3 pM1 pStage IV). Two months after the operation, the patient was diagnosed with recurrence in the neck lymph nodes and underwent chemotherapy; however, she died. A 66-year-old man with early-stage esophageal cancer underwent subtotal esophagectomy. A superficial early cancerous lesion was seen over BE. The postoperative pathological diagnosis was of well-differentiated adenocarcinoma without lymph node metastasis (pT1a pN0 pM0 pStage 0). The patient was found to be alive and recurrence-free 3 months after the operation.ConclusionsBEAC might show good prognosis if detected and treated early. Extremely LSBE is associated with a high incidence of BEAC; therefore, early detection and treatment with close surveillance is essential.
Highlights
Barrett’s esophagus (BE) is characterized by presence of columnar epithelium in the lower esophageal mucosa, which originally comprises stratified squamous epithelium
Long-segment BE (LSBE) is associated with a high incidence of BE adenocarcinoma (BEAC); early detection and treatment with close surveillance is essential
The postoperative pathological diagnosis was of poorly differentiated adenocarcinoma (T3 70 × 45 mm) with lymph node metastasis (N3)
Summary
Barrett’s esophagus (BE) is characterized by presence of columnar epithelium in the lower esophageal mucosa, which originally comprises stratified squamous epithelium. Case 1 A 66-year-old man with esophageal obstruction was admitted to a different hospital He was referred to our institution following diagnosis of BEAC. The postoperative pathological diagnosis was of poorly differentiated adenocarcinoma (T3 70 × 45 mm) with lymph node metastasis (N3) (pT3 pN3 pM0 pStage III; Fig. 1). The postoperative pathological diagnosis was of well-differentiated adenocarcinoma (60 × 52 mm) with supraclavicular lymph node metastasis (pT3 pN3 pM1 pStage IV; Fig. 2). Following diagnosis of cT1aN0M0 based on the Union for International Cancer Control TNM Classification 8th edition, subtotal esophagectomy was performed with lymph node and neck dissection. Diagnosis was of well-differentiated adenocarcinoma (143 × 56 mm) with no lymph node metastasis (pT1a pN0 pM0 pStage 0 based on the Union for International Cancer Control TNM Classification 8th edition; Fig. 3). The patient was found to be alive and recurrence-free 3 months after the operation
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call