Ectopic Sebacious Glands in the Esophageal Mucosa

Abstract

A white woman was referred to our department for further evaluation of pain in the right upper abdomen. er past medical history was significant for gastroesophageal eflux disease and rheumatoid arthritis. Physical examination as unremarkable. Gallbladder ultrasound revealed a 1-cm emangioma of the liver, otherwise unremarkable. An upper astrointestinal endoscopy showed patchy mild mucosal abnorality characterized by yellow circular spots in the middle third f the esophagus (30 cm from the upper incisors). Biopsies were aken from these areas (Figure A, B). The rest of the esophagus, tomach, and duodenum revealed no abnormality except for iny gastric erosions. Pathology of esophageal biopsy showed fragments of esophaeal mucosa showing sebaceous gland formation. The surroundng epithelium was histologically unremarkable (Figure C). Sebaceous glands in the esophagus are rare.1-5 The association between gastroesophageal reflux disease and presence of esophageal sebaceous glands is unknown. Sebaceous glands are normally found in association with hair follicles.1 Ectopic sebaceous glands have been reported in other tissues of ectodermal origin like the palms and soles, nipple, genitals, eyes and orbits, and parotid glands.3,4 The histogenesis of sebaceous glands in the esophagus is not clear. Several hypotheses have been postulated.3 The embryoogic misplacement of sebaceous glands at ectodermal tissue and metaplasia of submucosal glands are the 2 important hypotheses. The observation that most of the reported sebaceous glands were found in older patients supports the theory of metaplasia.3