Abstract
We report a case of mixed adenoendocrine carcinoma of the upper thoracic esophagus arising from ectopic gastric mucosa. A 64-year-old man who had been diagnosed with an esophageal tumor on the basis of esophagoscopy was referred to our hospital. Upper gastrointestinal endoscopy revealed the presence of ectopic gastric mucosa and an adjacent pedunculated lesion located on the posterior wall of the upper thoracic esophagus. Subtotal esophagectomy with three-field lymph node dissection was performed. A microscopic examination revealed that there was a partially intermingling component of neuroendocrine carcinoma adjacent to a tubular adenocarcinoma which was conterminous with the area of the ectopic gastric mucosa. Although the tubular adenocarcinoma was confined to the mucosa and submucosa, the neuroendocrine carcinoma had invaded the submucosaand there was vascular permeation. Each component accounted for 30% or more of the tumor, so the final histopathological diagnosis was mixed adenoendocrine carcinoma of the upper thoracic esophagus arising from ectopic gastric mucosa. Adjuvant chemotherapy was not performed, because the postoperative tumor stage was IA. The patient was well and had no evidence of recurrence 16 months after surgery.
Highlights
Most esophageal carcinomas are squamous cell carcinomas or adenocarcinomas arising from Barrett’s epithelium, whereas adenocarcinomas derived from the esophageal glands or ectopic gastric mucosa (EGM)are rare
We report a case of mixed adenoneuroendocrine carcinoma (MANEC) in the upper thoracic esophagus arising from EGM and provide a review of the pertinent literature
The patient was diagnosed with primary adenocarcinoma arising from EGM in the upper thoracic esophagus
Summary
Most esophageal carcinomas are squamous cell carcinomas or adenocarcinomas arising from Barrett’s epithelium, whereas adenocarcinomas derived from the esophageal glands or ectopic gastric mucosa (EGM)are rare. These cases arise mostly in the cervical or upper thoracic esophagus [1]. The patient was diagnosed with primary adenocarcinoma arising from EGM in the upper thoracic esophagus. He underwent radical esophagectomy with three-field lymphadenectomy. Six months after the surgery, resection of the pyloric ring and diversion of the gastric conduit was performed in a Rouxen-Y fashion to prevent repetitive aspiration of regurgitant For these reasons, it took approximately 8 months for the patient to safely resume oral intake. At the time of this writing, the patient has been doing well for 16 months, with no evidence of recurrence
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