Early esophageal adenocarcinoma arising in a short segment of Barrett's mucosa after total gastrectomy.
A 66-yr-old man had undergone a total gastrectomy with esophagojejunostomy for gastric cancer 29 yr previously. Soon after the operation, he began to suffer frequent bile regurgitation and subsequent alkaline reflux esophagitis. A small esophageal tumor was found incidentally above the esophagojejunostomy at a follow-up endoscopy, and he subsequently underwent a lower esophagectomy in 1995. The resected specimen revealed evidence of an early adenocarcinoma arising in a short segment of columnar cell-lined esophagus which had not been grossly evident prior to the esophagectomy. The present case indicates that columnar metaplasia with a neoplastic potential can be induced in the esophagus by the chronic reflux of duodenal contents in the absence of gastric acid.
Nishimaki
T
T
First Department of Surgery, Niigata University School of Medicine, Japan.
Watanabe
K
K
Suzuki
T
T
Hatakeyama
K
K
Watanabe
H
H
D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D004383:Duodenogastric Reflux / Q000150:complications*; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D005743:Gastrectomy; D006801:Humans; D008297:Male; D013997:Time Factors