Primary adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa

Abstract

Most esophageal malignancies are either squamous cell carcinomas or adenocarcinomas arising from Barrett's esophagus. We report a case of adenocarcinoma of the upper esophagus (cervical esophagus) that was derived from heterotopic gastric mucosa. In a 73-year-old man cervical esophagectomy was performed, followed by pharyngectomy, laryngectomy, and palliative dissection of lymph nodes on both sides of the neck, after an accurate diagnosis has been made by esophagography and endoscopy. The resected tumor was smoothly elevated (2.5 cm x 2.0 cm) and was microscopically identified as a well differentiated adenocarcinoma with invasion to the submucosa. The origin of the carcinoma was found to be a heterotopic gastric mucosa, by hematoxylin-eosin (H&E), immunohistochemical, and enzyme histochemical staining. To our knowledge, only 18 similar cases have been reported previously.

Adenocarcinoma of the upper esophagus arising in heterotopic gastric mucosa: common pathogenesis with Barrett's adenocarcinoma?

“…Adenocarcinomas developing on HGM have a poor prognosis. Only six reported patients were alive without evidence of disease at a short follow-up of 7-60 months [3,12,19,24,29,33], four were alive with recurrence 4-30 months after the diagnosis, and four had died 4-15 months after the diagnosis (Table 1).…”

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

“…Despite publications asserting that HGM is a benign condition, 25 cases of adenocarcinoma and 3 of high-grade dysplasia arising in such an inlet patch have so far been reported [7][8][9][10][11][12][13][14]. We report here low-grade dysplasia in an adenomatous polyp of the esophagus developing on pyloric-type HGM treated with endoscopic mucosal resection (EMR) and review the previous literature.…”

Ectopic gastric mucosa in the rectum mimicking an early depressed cancer treated by endoscopic mucosal resection

“…Unlike ours, more than 90 % of the report− ed cases were symptomatic, and com− plete relief could be obtained following treatment, including surgical resection or endoscopic polypectomy or ablation [3]. Sporadic cases of cancers have also been reported to arise from ectopic gastric mu− cosa [4]. Although our patient was asymptomatic, malignant transformation could not be totally denied.…”