title: Invasion of poorly differentiated adenocarcinoma to the deep muscularis mucosae may be an indicator of lymph node metastasis in Barrett's esophageal cancer.
abstract: A 48-year-old man underwent endoscopic submucosal dissection (ESD) for a protruding lesion with a preoperative diagnosis of superficial Barrett's esophageal adenocarcinoma. Histopathological examination of the resected specimen showed invasion of poorly differentiated adenocarcinoma to the deep muscularis mucosa, although the predominant histology was differentiated-type and there was no lymphovascular infiltration. Additional esophagectomy with nodal dissection was conducted for possible remnant tumor cells after informed consent was given, and uncovered the presence of a metastatic lymph node. Caution is advised in the treatment of Barrett's esophageal adenocarcinoma with invasion of poorly differentiated tumor cells into the deep muscularis mucosae.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sakaguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness