Adenocarcinoma of the cervical esophagus arising from ectopic gastric mucosa: report of two cases and review of the literature
- 343 Downloads
Esophageal adenocarcinoma arising from ectopic gastric mucosa (EGM) is extremely rare. We describe here two Japanese patients with adenocarcinoma of the cervical esophagus arising from EGM. Case 1 is a 62-year-old man who had slightly red EGM in the cervical esophagus on upper gastrointestinal endoscopy (UGE). Because the biopsy showed atypical glands that were suspicious for adenocarcinoma, endoscopic submucosal dissection was performed. Histopathological examination revealed that the lesion was a well-differentiated adenocarcinoma (pT1a MM). Lymphovascular invasion was absent, and the margins were free from carcinoma. Case 2 is a 57-year-old man who had an elevated lesion with a bleeding tendency in an area of EGM in the cervical esophagus on UGE. Adenocarcinoma was diagnosed in the biopsy. Because of the presence of enlarged lymph nodes (#106recL), preoperative chemoradiotherapy was performed to reduce the size of the adenocarcinoma and lymph nodes prior to resection of the cervical esophagus and reconstruction with free jejunal grafts. Histopathological examination revealed moderately differentiated adenocarcinoma (0-I, pT2N1M0, pStage II). In both cases, adenocarcinoma was surrounded by EGM, which led to the diagnosis of EGM-derived esophageal adenocarcinoma. Here, we report its immunohistochemical characteristics in the present cases and discuss the histogenesis.
KeywordsEsophageal adenocarcinoma Ectopic gastric mucosa Cervical esophagus
Compliance with ethical standards:
Conflict of Interest:
Kosuke Nomura, Toshiro Iizuka, Naoko Inoshita, Yasutaka Kuribayashi, Takahito Toba, Akihiro Yamada, Satoshi Yamashita, Tsukasa Furuhata, Daisuke Kikuchi, Akira Matsui, Toshifumi Mitani,Osamu Ogawa, Shu Hoteya, Masaki Ueno, Harushi Udagawa and Mitsuru Kaise have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
Informed consent was obtained from all patients for being included in the study.
- 1.Posner MC, Forastiere AA, Minsky BD. Cancer of the esophagus. In: Devita VT, Hellman S, Rosenberg SA, editors. Cancer: principles and practice of oncology. 7th edn. Philadelphia: Lippincott Williams & Wilkins; 2005. pp. 861–909.Google Scholar
- 14.Kubota S, Yamaguchi H, Shirao K. A case of adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa. Gastrointest Endosc. 1993;5:1255–60.Google Scholar
- 15.Takagi Y, Sato S, Kimura K. A case of primary intra-thoracic esophageal adenocarcinoma in ectopic gastric mucosa in an elderly patient. J Jpn Surg Assoc. 1994;55:390–4.Google Scholar
- 31.Sakai Y, Satoh S, Amano T, et al. A case of adenocarcinoma of the cervical esophagus arising from heterotopic gastric mucosa. Operation. 2005;59:541–4.Google Scholar
- 32.Nishida Y, Hosokawa M, Fujita M, et al. Adenocarcinoma of the cervical esophagus, report of a case. Stomach Intest. 2005;40:393–6.Google Scholar
- 35.Young OH, Jeong EH, Jin HL, et al. Adenocarcinoma arising from heterotopic gastric mucosa in cervical esophagus, a case report. Korean J Pathol. 2008;42:33–6.Google Scholar
- 37.Komori S, Osada S, Tanaka Y, et al. A case of esophageal adenocarcinoma arising from the ectopic gastric mucosa in the thoracic esophagus. Rare Tumor. 2010;2:e5.Google Scholar
- 38.Hirano A, Itoh K, Kawai Y, et al. A case of adenocarcinoma of the cervical esophagus arising from the heterotopic gastric mucosa. Gastroenterol Endosc. 2010;52:1533–40.Google Scholar
- 44.Nonaka K, Watanabe M, Yuruki H, et al. Narrow band imaging of adenocarcinoma arising from ectopic gastric mucosa in the upper esophagus. Endoscopy. 2013;45(Suppl 2 UCTN):E112–E113.Google Scholar