Achalasia complicated by multiple intramucosal carcinomas: report of a case.
A 56-year-old woman underwent a laparoscopic Heller-Dor operation for esophageal achalasia in June 2002. As dysphagia became exacerbated and the oral intake became extremely poor, an esophagectomy was thus considered to be indicated. In September 2005, a transhiatal esophagectomy was performed, and the esophagus was reconstructed using a gastric tube through the posterior mediastinum. The patient developed pneumonia postoperatively, but responded to conservative therapy and was discharged in good health 30 days after surgery. A histopathological analysis demonstrated degeneration and a loss of gangliocytes throughout the esophagus as well as the presence of seven intramucosal cancers. The main cause of dysphagia was due to a marked flexion of the upper esophagus. Even though we identified a precancerous state, we believe that surgery was an appropriate option in this case.
Kawasaki
Naruo
N
Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
Suzuki
Yutaka
Y
Omura
Nobuo
N
Tsuboi
Kazuto
K
Matsumoto
Akira
A
Kashiwagi
Hideyuki
H
Yanaga
Katsuhiko
K
D003680:Deglutition Disorders / Q000209:etiology*; D004931:Esophageal Achalasia / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence