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

Abstract 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 i...

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Main Authors: Naoki Kuwayama, Isamu Hoshino, Hisashi Gunji, Toru Tonooka, Hiroaki Soda, Ryotaro Eto, Nobuhiro Takiguchi, Yoshihiro Nabeya
Format: Article
Language:English
Published: Japan Surgical Society 2020-09-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-020-00995-7
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author Naoki Kuwayama
Isamu Hoshino
Hisashi Gunji
Toru Tonooka
Hiroaki Soda
Ryotaro Eto
Nobuhiro Takiguchi
Yoshihiro Nabeya
author_facet Naoki Kuwayama
Isamu Hoshino
Hisashi Gunji
Toru Tonooka
Hiroaki Soda
Ryotaro Eto
Nobuhiro Takiguchi
Yoshihiro Nabeya
author_sort Naoki Kuwayama
collection DOAJ
description Abstract 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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spelling doaj-art-1b98068e86184dabba3d9984f705742e2025-08-20T02:42:02ZengJapan Surgical SocietySurgical Case Reports2198-77932020-09-01611710.1186/s40792-020-00995-7Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 casesNaoki Kuwayama0Isamu Hoshino1Hisashi Gunji2Toru Tonooka3Hiroaki Soda4Ryotaro Eto5Nobuhiro Takiguchi6Yoshihiro Nabeya7Division of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterDivision of Gastroenterological Surgery, Chiba Cancer CenterAbstract 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.http://link.springer.com/article/10.1186/s40792-020-00995-7Barrett's esophagusAdenocarcinomaSurveillance
spellingShingle Naoki Kuwayama
Isamu Hoshino
Hisashi Gunji
Toru Tonooka
Hiroaki Soda
Ryotaro Eto
Nobuhiro Takiguchi
Yoshihiro Nabeya
Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
Surgical Case Reports
Barrett's esophagus
Adenocarcinoma
Surveillance
title Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
title_full Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
title_fullStr Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
title_full_unstemmed Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
title_short Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
title_sort adenocarcinoma originating from long segment barrett s esophagus over 15 cm a series of 3 cases
topic Barrett's esophagus
Adenocarcinoma
Surveillance
url http://link.springer.com/article/10.1186/s40792-020-00995-7
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