A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy

Abstract Esophageal varices (EVs) are often treated using endoscopic injection sclerotherapy. Endoscopic submucosal dissection (ESD) has been used for early esophageal epithelial neoplasia worldwide. We report a case of early esophageal squamous cell carcinoma (ESCC) that occurred over EVs, in which...

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Main Authors: Kenichiro Nakachi, Takao Maekita, Hisanobu Deguchi, Masatomo Kimura, Mikitaka Iguchi, Satoshi Yoshida, Masayuki Kitano
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.202
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author Kenichiro Nakachi
Takao Maekita
Hisanobu Deguchi
Masatomo Kimura
Mikitaka Iguchi
Satoshi Yoshida
Masayuki Kitano
author_facet Kenichiro Nakachi
Takao Maekita
Hisanobu Deguchi
Masatomo Kimura
Mikitaka Iguchi
Satoshi Yoshida
Masayuki Kitano
author_sort Kenichiro Nakachi
collection DOAJ
description Abstract Esophageal varices (EVs) are often treated using endoscopic injection sclerotherapy. Endoscopic submucosal dissection (ESD) has been used for early esophageal epithelial neoplasia worldwide. We report a case of early esophageal squamous cell carcinoma (ESCC) that occurred over EVs, in which the EVs were treated with endoscopic injection sclerotherapy before the early ESCC was treated with endoscopic submucosal dissection. Argon plasma coagulation was finally performed to prevent the recurrence of varices. No serious complications, such as severe bleeding or perforation, were observed. Histopathological examination revealed submucosal veins occluded with an organized thrombus for which endoscopic injection sclerotherapy with an intravariceal injection of sclerosant had been performed, but no fibrosis was observed outside the blood vessels. This explains that the injected sclerosant into EVs did not cause any tissue reaction like fibrosis in the submucosa surrounding the vein, which may have made endoscopic submucosal dissection safer and easier. Varices have not recurred, and ESCC has also not recurred for 5 years. We demonstrated a successful treatment of ESCC on EVs and no submucosal fibrosis other than inside the occluded vessels and verified it histologically.
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issn 2692-4609
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spelling doaj-art-220acd9d225d47e3b45fbc412236a3fd2025-08-20T03:10:01ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.202A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapyKenichiro Nakachi0Takao Maekita1Hisanobu Deguchi2Masatomo Kimura3Mikitaka Iguchi4Satoshi Yoshida5Masayuki Kitano6GastroenterologicalMedicine Kameda Medical Center Kamogawa Chiba JapanDepartment of Gastroenterology Wakayama Medical University Wakayama JapanInternal Medicine Nokami Kousei Sogo Hospital Wakayama JapanDepartment of Pathology Hashimoto Municipal Hospital Wakayama JapanDepartment of Gastroenterology Wakayama Medical University Wakayama JapanGastroenterological Medicine Hashimoto Municipal Hospital Wakayama JapanDepartment of Gastroenterology Wakayama Medical University Wakayama JapanAbstract Esophageal varices (EVs) are often treated using endoscopic injection sclerotherapy. Endoscopic submucosal dissection (ESD) has been used for early esophageal epithelial neoplasia worldwide. We report a case of early esophageal squamous cell carcinoma (ESCC) that occurred over EVs, in which the EVs were treated with endoscopic injection sclerotherapy before the early ESCC was treated with endoscopic submucosal dissection. Argon plasma coagulation was finally performed to prevent the recurrence of varices. No serious complications, such as severe bleeding or perforation, were observed. Histopathological examination revealed submucosal veins occluded with an organized thrombus for which endoscopic injection sclerotherapy with an intravariceal injection of sclerosant had been performed, but no fibrosis was observed outside the blood vessels. This explains that the injected sclerosant into EVs did not cause any tissue reaction like fibrosis in the submucosa surrounding the vein, which may have made endoscopic submucosal dissection safer and easier. Varices have not recurred, and ESCC has also not recurred for 5 years. We demonstrated a successful treatment of ESCC on EVs and no submucosal fibrosis other than inside the occluded vessels and verified it histologically.https://doi.org/10.1002/deo2.202early esophageal squamous cell carcinomaendoscopic injection sclerotherapyendoscopic submucosal dissectionesophageal varixesophagogastroduodenoscopy
spellingShingle Kenichiro Nakachi
Takao Maekita
Hisanobu Deguchi
Masatomo Kimura
Mikitaka Iguchi
Satoshi Yoshida
Masayuki Kitano
A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
DEN Open
early esophageal squamous cell carcinoma
endoscopic injection sclerotherapy
endoscopic submucosal dissection
esophageal varix
esophagogastroduodenoscopy
title A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
title_full A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
title_fullStr A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
title_full_unstemmed A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
title_short A case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
title_sort case of esophageal carcinoma on esophageal varices treated by endoscopic submucosal dissection after endoscopic injection sclerotherapy
topic early esophageal squamous cell carcinoma
endoscopic injection sclerotherapy
endoscopic submucosal dissection
esophageal varix
esophagogastroduodenoscopy
url https://doi.org/10.1002/deo2.202
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