title: Recurrence of intramucosal esophageal adenocarcinoma arising in a former esophagostomy site: a unique case report.
abstract: A 75-year-old male with a long history of gastroesophageal reflux symptoms developed adenocarcinoma proximally within a long segment of Barrett's esophagus. He was taken for esophagectomy and gastric pull-up, but intraoperatively, he was found to have a marginal blood supply in the gastric tube. A temporary left-sided esophagostomy was created with the gastric tube sutured to the left sternocleidomastoid muscle in the neck. Pathology showed an intramucosal adenocarcinoma, limited to the muscularis mucosa with surrounding high-grade dysplasia and intestinal metaplasia. The proximal esophageal margin showed no tumor cells, but there was low-grade dysplasia within Barrett's esophagus. He was reconstructed after several months, and 2 years after reconstruction, the patient noticed a nodule at the former esophagostomy site. Biopsy revealed an implant metastasis of esophageal adenocarcinoma. Here, we review the literature and discuss the possible etiology.
authors.affiliation: Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Leers
authors.forename: S R
authors.initials: SR
authors.lastname: DeMeester
authors.forename: S
authors.initials: S
authors.lastname: Ayazi
authors.forename: A L
authors.initials: AL
authors.lastname: Tang
authors.forename: C G
authors.initials: CG
authors.lastname: Peyre
authors.forename: J C
authors.initials: JC
authors.lastname: Lipham
authors.forename: J A
authors.initials: JA
authors.lastname: Hagen
authors.forename: T R
authors.initials: TR
authors.lastname: DeMeester
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology; D004938:Esophageal Neoplasms / Q000473:pathology*; D004946:Esophagostomy / Q000379:methods; D006801:Humans; D008297:Male; D009092:Mucous Membrane / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009366:Neoplasm Seeding