Abstract
IntroductionStandard endoscopic mucosal resection or endoscopic submucosal dissection is a procedure for patients with minute cancers, complicated with esophageal varices that puts them at high risk of bleeding.Case presentationWe present the case of a 77-year-old Japanese man with alcoholic cirrhosis who underwent a routine endoscopy examination as a screening procedure for esophageal varices and was incidentally diagnosed as having minute cancer of the esophagogastric junction with esophageal varices. Endoscopic ultrasonography findings suggested that the minute cancer was a non-invasive carcinoma (carcinoma in situ) and a 2 mm in diameter blood vessel, feeding the esophageal varices, pierced the lesion. Following the examination, we carried out endoscopic treatment of the minute cancer and esophageal varices. Endoscopic variceal ligation was performed using a pneumo-activated device (Sumitomo Bakelite, Tokyo, Japan). Two years after the treatment, during the follow-up endoscopic examination on the patient, recurrence of carcinoma was not detected endoscopically or histologically.ConclusionEndoscopic therapy using an endoscopic variceal ligation device for minute cancer of the esophagogastric junction, complicated with esophageal varices, may be an acceptable and easily applicable method.
Highlights
Standard endoscopic mucosal resection or endoscopic submucosal dissection is a procedure for patients with minute cancers, complicated with esophageal varices that puts them at high risk of bleeding.Case presentation: We present the case of a 77-year-old Japanese man with alcoholic cirrhosis who underwent a routine endoscopy examination as a screening procedure for esophageal varices and was incidentally diagnosed as having minute cancer of the esophagogastric junction with esophageal varices
Minute cancer is a gastric cancer lesion of less than 5 mm in its maximum diameter, with tumor cells confined to the mucosa
These characteristics of minute cancer provide the basis for using endoscopic therapy as a curative treatment [3]
Summary
Minute cancer is a gastric cancer lesion of less than 5 mm in its maximum diameter, with tumor cells confined to the mucosa. Are extremely rare [1,2] These characteristics of minute cancer provide the basis for using endoscopic therapy as a curative treatment [3]. We describe endoscopic therapy using an endoscopic variceal ligation (EVL) device for minute cancer complicated with esophageal varices. Case presentation A 77-year-old Japanese man with alcoholic cirrhosis had been undergoing a follow-up laboratory examination every month for three years. Following the EUS examination, we carried out endoscopic treatment of the minute cancer and esophageal. EVL was successively done for the esophageal varices in three places. A follow-up examination after two years did not show recurrence of the disease (Figure 5)
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