Recurrence of intramucosal esophageal adenocarcinoma arising in a former esophagostomy site: a unique case report.
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.
Leers
J M
JM
Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
DeMeester
S R
SR
Ayazi
S
S
Tang
A L
AL
Peyre
C G
CG
Lipham
J C
JC
Hagen
J A
JA
DeMeester
T R
TR
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