Ewha Med J.  2012 Sep;35(2):124-128. 10.12771/emj.2012.35.2.124.

A Case of Early Adenocarcinoma at Esophagogastric Junction Treated with Cap-pitted Endoscopic Mucosal Resection

• So YR
• Kim DH
• Yun HA
• Seok HY
• Hong SH
• Jung SW
• Cha JM
• Lee JI
• Joo KR
• Shin HP
• Park JJ
• Jeoun JW

• KMID: 2284004
• DOI: http://doi.org/10.12771/emj.2012.35.2.124

Abstract

Surgery is the primary treatment for adenocarcinoma originating from the esophagogastric junction. However, many physicians attempt various endoscopic treatments for the cases of early adenocarcinoma and high-grade dysplasia of esophagogastric junction in order to avoid the high risk of complications associated with surgical resection. Recently, there is an increasing tendency to use endoscopic mucosal resection for the management of early esophageal cancer due to low morbidity and mortality rates. We report here on a case of early adenocarcinoma at esophagogastric junction successfully treated with endoscopic mucosal resection.

Keyword

Adenocarcinoma; Endoscopy; Esophagogastric junction

MeSH Terms

Adenocarcinoma
Endoscopy
Esophageal Neoplasms
Esophagogastric Junction

Figure

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  Fig. 1 An endoscopic finding. Endoscopy finding shows a 10×15 mm sized polyp, which mimics a sentinel polyp at the esophagogastric junction. White exudate is noted at the top of polyp, however, any ulcer or bleeding is not noted at the surface of polyp.

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  Fig. 2 Abdominal computed tomography. It does not show a demonstrable mass or abnormal wall thickening at the esophagogastric junction.

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  Fig. 3 Endoscopic findings. (A) Early cancer of esophagogastic junction, which is completely resected with cap-pitted endoscopic mucosal resection. Sufficient amount of normal mucosa (white dot line) is secured under the base of malignant polyp. (B) Endoscopic resection is complete without any remnant lesions.

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  Fig. 4 Pathologic findings. The specimen shows moderate differentiated adenocarcinoma (arrows) with negative deep and lateral margins (H&E, ×20). The adenocarcinoma is confined within the mucosal layer, however, focal 500 µm submucosal invasion is noted (arrow heads).

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