Endoscopic resection combined with radiofrequency ablation for early adenocarcinoma in Barrett's esophagus

Abstract

Barrett’s esophagus (BE) is a premalignant condition that results from the replacement of the normal squamous lining of the esophagus by a columnar epithelium containing intestinal metaplasia (IM) on biopsy. A 53-year-old man was followed at our institution for long-segment BE (Prague classification C1 M4) since 2007. His past medical history was unremarkable. There were no visible nodules or ulcerations within the BE at endoscopy in 2007 and 2008. Biopsies, performed according to the Seattle protocol, were negative for dysplasia. The patient returned in 2011 for surveillance endoscopy. At this exam a flat, slightly elevated, lesion (Paris classification 0-IIa) with 8mm of diameter was noted near the gastroesophageal junction (Fig. 1A). Targeted biopsies were compatible with intramucosal adenocarcinoma. Biopsy specimens of the remainder BE were negative for dysplasia. Endoscopic mucosal resection (EMR) was performed with the patient under deep sedation with propofol. We used the Duette Multiband Mucosectomy KitTM