Abstract
A 43-year-old man presented with severe back pain. He had a history of morbid obesity, for which an esophagogastric silicone band was placed 2 years before presentation. Magnetic resonance imaging of the vertebral column showed multiple osseous metastases. On the computerized tomography scan of the abdomen, a tumor of the lower esophagus just proximal to the esophagogastric band was seen, of which histological examination revealed an esophageal adenocarcinoma. Esophageal adenocarcinoma after bariatric surgery has been described previously in only a few cases. Although there is no evidence for a causal relationship with bariatric surgery, one should bear in mind that the incidence of esophageal adenocarcinoma is increased in patients with morbid obesity because of the higher incidence of gastroesophageal reflux disease. Also, the symptoms of adenocarcinoma might be masked after bariatric surgery.
References
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery. A systematic review and meta-analysis. JAMA 2004;292:1724–37.
Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–24.
Anwar M, Collins J, Kow L, et al. Long-term efficacy of a low-pressure adjustable gastric band in the treatment of morbid obesity. Ann Surg. 2008;247:771–8.
de Roover A, Detry O, Desaive C, et al. Risk of upper gastrointestinal cancer after bariatric operations. Obes Surg. 2006;16:1656–61.
Snook KL, Ritchie JD. Carcinoma of esophagus after adjustable gastric banding. Obes Surg. 2003;13:800–2.
Allen JW, Leeman MF, Richardson JD. Esophageal carcinoma following bariatric procedures. J Soc Laparoendosc Surg. 2004;8:372–5.
Parikh AA, Vaporciyan AA, Swisher SG. Chapter 8, Esophageal carcinoma. In: Feig BW, Berger DH, Fuhrman GM, editors. The M.D. Anderson surgical oncology handbook. Philadelphia: Lippincott, Williams and Wilkins; 2003. p. 145–57.
Botterweck AA, Schouten LJ, Volovics A, et al. Trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in ten European countries. Int J Epidemiol. 2000;29:645–54.
Devesa SS, Blot WJ, Fraumeni J-FJ. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer 1998;83:2049–53.
Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143:199–211.
Shaheen N, Ransohoff DF. Gastroesophageal reflux, barrett esophagus, and esophageal cancer: clinical applications. JAMA 2002;287:1972–81.
Sauerland S, Angrisani L, Belachew M, et al. Obesity surgery: evidence-based guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc. 2005;19:200–21.
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The author would like to give thanks to B.J. Borgstein (radiologist) and F.E. Bellot (pathologist) of the Spaarne Hospital for the permission to use the pictures.
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Korswagen, LA., Schrama, J.G., Bruins Slot, W. et al. Adenocarcinoma of the Lower Esophagus After Placement of a Gastric Band. OBES SURG 19, 389–392 (2009). https://doi.org/10.1007/s11695-008-9718-1
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DOI: https://doi.org/10.1007/s11695-008-9718-1