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Esophageal adenocarcinoma arising in cervical inlet patch with synchronous Barrett's esophagus-related dysplasia.
[esophageal adenocarcinoma]
Esophageal
adenocarcinomas
usually
develop
in
Barrett
's
esophagus
,
typically
through
the
metaplasia-dysplasia-carcinoma
sequence
,
but
adenocarcinomas
can
occur
from
heterotopic
gastric
mucosa
in
cervical
esophagus
(
inlet
patch
)
.
This
report
describes
the
first
case
of
synchronous
presentation
of
adenocarcinoma
arising
from
cervical
inlet
patch
and
Barrett
's
esophagus
-related
dysplasia
in
a
76
-
year
-old
man
.
Surveillance
CT
detected
a
3
-
cm
polypoid
mass
in
the
cervical
esophagus
.
Endoscopic
biopsies
confirmed
a
diagnosis
of
adenocarcinoma
of
the
cervical
esophagus
.
Barrett
's
esophagus
was
present
also
in
the
lower
esophagus
.
Histologic
examination
of
the
surgically
resected
specimen
revealed
the
polypoid
mass
as
composed
of
tubular
adenocarcinoma
,
and
was
associated
with
non-neoplastic
columnar
mucosa
representing
pre-existing
inlet
patch
.
Another
isolated
cervical
inlet
patch
with
intestinal
metaplasia
was
also
recognized
.
In
the
lower
esophagus
,
high
-grade
dysplasia
was
noted
within
the
Barrett
's
esophagus
.
Immunohistochemically
,
the
adenocarcinoma
associated
with
inlet
patch
had
intestinal
immunophenotype
(
CDX
2
-
,
CD
10
-
and
MUC
2
-
positive
)
,
whereas
the
Barrett
's
esophagus
-related
high
-grade
dysplasia
showed
mixed
immunophenotype
(
MUC
5
AC
-
and
MUC
6
-
positive
,
with
scattered
MUC
2
-
positive
goblet
cells
)
.
Previous
studies
and
our
findings
suggest
that
intestinal
metaplasia
might
predispose
to
the
development
of
adenocarcinoma
in
the
inlet
patch
.
Therefore
,
endoscopists
and
pathologists
should
be
aware
of
rare
malignant
transformation
of
inlet
patches
,
especially
those
with
intestinal
metaplasia
.
Diseases
Validation
Diseases presenting
"first case"
symptom
achondroplasia
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
aniridia
aromatase deficiency
canavan disease
carcinoma of the gallbladder
child syndrome
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
esophageal adenocarcinoma
esophageal carcinoma
fabry disease
familial mediterranean fever
focal myositis
gm1 gangliosidosis
harlequin ichthyosis
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
krabbe disease
lamellar ichthyosis
legionellosis
liposarcoma
locked-in syndrome
malignant atrophic papulosis
monosomy 21
neonatal adrenoleukodystrophy
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
systemic capillary leak syndrome
thoracic outlet syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
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