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Coexistent multiple adenocarcinomas arising in Barrett’s esophagus 23 years after total gastrectomy and esophageal small cell carcinoma

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Abstract

A 69-year-old Japanese man undergoing total gastrectomy for multiple gastric ulcers at age 46 was found endoacopically to have multiple esophageal cancers in the upper, mid, and lower esophagus. Esophageal mucosa associated with tumors was replaced with columnar epithelium. He underwent total esophagectomy combined with laryngectomy, pharyngectomy, and lymph node dissection using the large bowel for reconstruction. The resected esophagus had multiple cancers, including well-differentiated adenocarcinoma, poorly differentiated adenocarcinoma, and small-cell carcinoma. Barrett's mucosa consisted mainly of specialized columnar epithelium while both junctional and fundic Barrett's epithelium was observed partially but not clearly. This case is indicative of the high and totipotential carcinogenetic risk of Barrett's epithelium and the relationship between duodenal content reflux and esophageal carcinogenesis after total gastrectomy.

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References

  1. Seto Y, Kobori O. Role of reflux oesophagitis and acid in the development of columnar epithelium in the rat oesophagus. Br J Surg 1993; 80: 467–70.

    Article  PubMed  CAS  Google Scholar 

  2. Miwa K, Sahara H, Segawa M, Kinami S, Sato T, Miyazaki, I, et al. Reflux of duodenal or gastro-duodenal contents induces esophageal carcinoma in rats. Int J Cancer 1996; 67: 269–74.

    Article  Google Scholar 

  3. Pera M, Brito MJ, Poulsom R, Riera E, Grande L, Hanby A, et al. Duodenal-content reflux esophagitis induces the development of glandular metaplasia and adenosquamous carcinoma in rats. Carcinogenesis 2000; 21: 1587–91.

    Article  PubMed  CAS  Google Scholar 

  4. Meyer W, Vollmar F, Bar W. Barrett-esophagus following total gastrectomy: A contribution to it's pathogenesis. Endoscopy 1979; 11: 121–6.

    Article  PubMed  CAS  Google Scholar 

  5. Sandvik AK, Halvorsen TB. Barrett's esophagus after total gastrectomy. J Clin Gastroenterol 1988; 10: 587–8.

    Article  PubMed  CAS  Google Scholar 

  6. Fein M, Peters JH, Baril N, McGarvey M, Chandrasoma P, Shibata D, et al. Loss of function of Trp53, but not Apc, leads to the development of esophageal adenocarcinoma in mice with jejunoesophageal reflux. J Surg Res 1999; 83: 48–55.

    Article  PubMed  CAS  Google Scholar 

  7. Kawaura Y, Tatsuzawa Y, Wakabayashi T, Ikeda N, Matsuda M, Nishihara S. Immunohistochemical study of p53, c-erbB-2, and PCNA in Barrett's esophagus with dysplasia and adenocarcinoma arising from experimental acid or alkaline reflux model. J Gastroenterol 2001; 36: 595–600.

    Article  PubMed  CAS  Google Scholar 

  8. Noguchi T, Takeno S, Uchida Y, Shimoda H, Daa T, Yokoyama S. Clinicopathological and immunohistochemical study of cancer arising from Barrett's esophagus. Oncol Rep 1999; 6: 1293–7.

    PubMed  CAS  Google Scholar 

  9. Kimura H, Konishi K, Inoue T, Earashi M, Maeda K, Yabushita K, et al. Primary small cell carcinoma of the esophagus: Flow cytometric analysis and immunohistochemical staining for the p53 protein and proliferating cell nuclear antigen. J Surg Oncol 1998; 68: 246–9.

    Article  PubMed  CAS  Google Scholar 

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Noguchi, T., Takeno, S., Sato, T. et al. Coexistent multiple adenocarcinomas arising in Barrett’s esophagus 23 years after total gastrectomy and esophageal small cell carcinoma. Jpn J Thorac Caridovasc Surg 51, 259–262 (2003). https://doi.org/10.1007/s11748-003-0026-3

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  • DOI: https://doi.org/10.1007/s11748-003-0026-3

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