Low-grade dysplasia in an adenomatous polyp of the esophagus developing on pyloric-type heterotopic gastric mucosa treated with endoscopic mucosal resection: a case report

Hayashi, Toshimitsu; Takizawa, Kazuyasu; Kobayashi, Kazuo; Watanabe, Naozumi; Ikarashi, Taro

doi:10.1007/s10388-005-0056-2

Cited by 1 publication

(3 citation statements)

References 14 publications

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“…20 High-dose omeprazole combined with endoscopic thermal coagulation resulted in long-term improvement of dysphagia in a patient with an IP and a stricture, and eventually led to repopulation of the area with normal squamous epithelium. 21 Our group, 24 as well as others, 25,26 has shown successful long-term resolution of symptoms with EMR in three individual case reports. Hayashi et al 26 described a case of successful EMR of a 1.5 cm IP with low-grade dysplasia, with no evidence of recurrence after a 3-year follow-up.…”

Section: Treatment Optionsmentioning

confidence: 81%

“…21 Our group, 24 as well as others, 25,26 has shown successful long-term resolution of symptoms with EMR in three individual case reports. Hayashi et al 26 described a case of successful EMR of a 1.5 cm IP with low-grade dysplasia, with no evidence of recurrence after a 3-year follow-up. Further, Oguma et al 25 resected a hyperplastic polyp arising from IP with no symptoms or evidence of recurrence at 8 months follow-up.…”

Section: Treatment Optionsmentioning

confidence: 81%

“…Hayashi et al. 26 described a case of successful EMR of a 1.5 cm IP with low‐grade dysplasia, with no evidence of recurrence after a 3‐year follow‐up. Further, Oguma et al.…”

Section: Review Of the Literaturementioning

confidence: 99%

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Heterotopic gastric mucosa (inlet patch) in a patient with laryngopharyngeal reflux (LPR) and laryngeal carcinoma: a case report and review of literature

Basseri

Conklin

Mertens

et al. 2009

Diseases of the Esophagus

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The inlet patch is an area of heterotopic gastric mucosa most commonly located in the postcricoid portion of the esophagus at, or just below, the level of the upper esophageal sphincter. Esophageal and supraesophageal symptoms are commonly associated with inlet patch, while esophageal adenocarcinoma rarely complicates it. Laryngeal adenocarcinoma associated with inlet patch is not described in the literature. Herein, we present the first reported case of inlet patch associated with laryngeal carcinoma. A 33-year-old female with long-standing asthma and presumed gastroesophageal reflux developed laryngeal cancer at age 22 years that was treated with concomitant radiation and induction chemotherapy. Subsequently, she had refractory heartburn, dysphagia, and cough. These symptoms continued despite two Nissen fundoplications, glottic web division, and optimal medical management. Upper endoscopy at our institution revealed an upper esophageal stricture and a 1 cm inlet patch. Biopsies showed columnar mucosa (predominantly gastric cardiac/fundic type) consistent with inlet patch, with focal intestinal metaplasia. Subsequent endoscopic mucosal resection of the inlet patch resulted in an amelioration of throat and chest pain, cough, and hoarseness. Dysphagia and regurgitation were improved by serial dilatations of the upper esophageal stricture. This case reveals a number of clinical findings associated with inlet patch--chest pain, dysphagia, cough, and hoarseness--as well as a clinical finding that has not been previously associated with inlet patch: laryngeal cancer. Symptoms refractory to optimal medical management and/or surgical intervention should make the clinician and endoscopist more cognizant of the inlet patch.

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