title: Endoscopic therapy using an endoscopic variceal ligation for minute cancer of the esophagogastric junction complicated with esophageal varices: a case report.
abstract: BACKGROUND
  Standard endoscopic mucosal resection or endoscopic submucosal dissection is a procedure for patients with minute cancers, complicated with esophageal varices that puts them at high risk of bleeding.
  
  
  METHODS
  We present the case of a 77-year-old Japanese man with alcoholic cirrhosis who underwent a routine endoscopy examination as a screening procedure for esophageal varices and was incidentally diagnosed as having minute cancer of the esophagogastric junction with esophageal varices. Endoscopic ultrasonography findings suggested that the minute cancer was a non-invasive carcinoma (carcinoma in situ) and a 2 mm in diameter blood vessel, feeding the esophageal varices, pierced the lesion. Following the examination, we carried out endoscopic treatment of the minute cancer and esophageal varices. Endoscopic variceal ligation was performed using a pneumo-activated device (Sumitomo Bakelite, Tokyo, Japan). Two years after the treatment, during the follow-up endoscopic examination on the patient, recurrence of carcinoma was not detected endoscopically or histologically.
  
  
  CONCLUSIONS
  Endoscopic therapy using an endoscopic variceal ligation device for minute cancer of the esophagogastric junction, complicated with esophageal varices, may be an acceptable and easily applicable method.
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, Japan. inamorim@med.yokohama-cu.ac.jp.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akiyama
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hosono
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yoneda
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Akihide
authors.initials: A
authors.lastname: Ryo
authors.forename: Shoji
authors.initials: S
authors.lastname: Yamanaka
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inayama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima