Three Cases of Adenocarcinoma Arising in Extremely Long-Segment Barrett’s Esophagus

Fujiwara, Toshiya; Naomoto, Yoshio; Yamatsuji, Tomoki; Shirakawa, Yasuhiro; Noguchi, Hirofumi; Fujiwara, Toshiyoshi; Oohara, Nobuya; Gündüz, Mehmet; Nagatsuka, Hitoshi; Nishie, Manabu; Uetsuka, Hirokazu; Hamazaki, Shuji; Tanaka, Noriaki

doi:10.1007/s10620-006-3166-3

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…The detection frequency of LSBE larger than 13 cm is 1.27% (15/1175) [7], and it is conceivable that LSBE larger than 15 cm is a relatively uncommon condition. Until now, nine cases have been reported in the literature [8][9][10][11][12][13][14][15] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases

et al. 2020

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Background Barrett's esophagus (BE) is characterized by presence of columnar epithelium in the lower esophageal mucosa, which originally comprises stratified squamous epithelium. Gastroesophageal reflux disease causes BE and BE adenocarcinoma (BEAC); further, the incidence of BEAC is increasing, especially in developed countries. Long-segment BE (LSBE) has a particularly high carcinogenic potential and necessitates treatment, surveillance, and prevention. Case presentation Herein, we report three cases of BEAC originating from LSBE larger than 15 cm. All three patients underwent surgery for the diagnosis of BEAC. A 66-year-old man with advanced esophageal cancer underwent neoadjuvant chemotherapy and subsequent subtotal esophagectomy. The postoperative pathological diagnosis was of poorly differentiated adenocarcinoma with lymph node metastasis (pT3 pN3 pM0 pStage III based on the Union for International Cancer Control TNM Classification 8th edition). Two years after the operation, the patient was diagnosed with recurrence around the celiac artery and underwent chemotherapy. An 83-year-old woman with advanced esophageal cancer underwent subtotal esophagectomy. The postoperative pathological diagnosis was of well-differentiated adenocarcinoma with supraclavicular lymph node metastasis (pT3 pN3 pM1 pStage IV). Two months after the operation, the patient was diagnosed with recurrence in the neck lymph nodes and underwent chemotherapy; however, she died. A 66-year-old man with early-stage esophageal cancer underwent subtotal esophagectomy. A superficial early cancerous lesion was seen over BE. The postoperative pathological diagnosis was of well-differentiated adenocarcinoma without lymph node metastasis (pT1a pN0 pM0 pStage 0). The patient was found to be alive and recurrence-free 3 months after the operation. Conclusions BEAC might show good prognosis if detected and treated early. Extremely LSBE is associated with a high incidence of BEAC; therefore, early detection and treatment with close surveillance is essential.

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Section: Discussionmentioning

confidence: 99%

Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases

et al. 2020

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“…Moreover, the backflow time of acid in the stomach and bile toward the esophagus are remarkably extended in LSBE, and it has been pointed out that this may be involved in the development of Barrett's esophagus [24]. According to a case series on adenocarcinoma with LSBE in Japan [31], including post-gastrectomy cases, the length of LSBE was 14-22 cm. This suggests an association of not only acid, but also alkali, with progression of LSBE.…”

Section: Discussionmentioning

confidence: 99%

A rare case of advanced esophageal adenocarcinoma with exceedingly long-segment Barrett’s esophagus

et al. 2013

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A 71-year-old male patient was admitted to our hospital with dysphagia. Upper gastrointestinal endoscopy revealed severe stenosis between 26 and 36 cm from the incisors, and biopsy specimens taken from the stenotic lesion showed well-differentiated adenocarcinoma. A longsegment Barrett's esophagus (LSBE) between 25 and 40 cm from the incisors was diagnosed. Subtotal esophagectomy with right thoracotomy was performed. Pleural tumor dissemination was seen 7 months later and was treated with chemotherapy. However, the patient died 14 months postoperatively. In Western countries, the incidence of adenocarcinoma in Barrett's esophagus is high, but in Japan, the incidence is very low. In Japan, the incidence of short-segment Barrett's esophagus is high, but that of LSBE is very low. We herein report esophageal adenocarcinoma in an exceedingly long LSBE of 15 cm.

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“…In contrast to Western countries, esophageal adenocarcinomas and LSBE are extremely uncommon in Japan. There have several reports of adenocarcinoma arising from LSBE of Japanese patients [5][6][7][8]. In the questionnaire for "Refl ux esophagitis and esophageal carcinoma" by the Japan Esophageal Society in 1999, 69 cases of Barrett's adenocarcinoma were counted and 36 (52.2%) of them had arisen from LSBE.…”

Section: Introductionmentioning

confidence: 99%

Multiple lesions of adenocarcinoma with extensive dysplasia in long-segment Barrett’s esophagus treated with thoracoscopic surgery: a case report

et al. 2009

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In contrast to Western countries, in Japan esophageal adenocarcinoma and classic Barrett's esophagus (long-segment Barrett's esophagus) have been considered extremely uncommon. Although alternative therapeutic techniques such as endoscopic ablation, photodynamic therapy, and endoscopic mucosal resection have been improved, esophagectomy remains the gold standard treatment for high-grade dysplasia and/or early adenocarcinoma of the esophagus. Recently, minimally invasive operational procedures have been developed as a safe and feasible alternative technique to traditional open techniques, which has enabled us to expand the indication. In this report, we describe a Japanese case of multiple lesions of adenocarcinoma in long-segment Barrett's esophagus, resected by thoracoscopic surgery. Our experience indicates that thoracoscopic esophagectomy could be one of the treatment options for multiple malignant or extensive precancerous lesions in long-segment Barrett's esophagus.

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Three Cases of Adenocarcinoma Arising in Extremely Long-Segment Barrett’s Esophagus

Cited by 3 publications

References 22 publications

Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases

Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases

A rare case of advanced esophageal adenocarcinoma with exceedingly long-segment Barrett’s esophagus

Multiple lesions of adenocarcinoma with extensive dysplasia in long-segment Barrett’s esophagus treated with thoracoscopic surgery: a case report

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