title: High-dose dexamethasone may prevent esophageal stricture after endoscopic submucosal dissection.
abstract: We report a rare case of esophageal endoscopic submucosal dissection (ESD) in a patient who underwent high-dose dexamethasone therapy for multiple myeloma shortly after ESD. A 61-year-old male was referred for treatment of esophageal superficial squamous cell carcinoma and underwent curative ESD. During his hospitalization for ESD, further examination for worsening back pain and gait disorder revealed multiple myeloma with multiple bone metastases. Consequently, high-dose dexamethasone therapy (40 mg × 4 days × 3 courses) was started on the 9th day after ESD. He was successfully treated by the subsequent peripheral blood stem cell transplantation. In the follow-up endoscopies, the artificial ulcer was shown to have re-epithelialized gradually with little or no size reduction of the ulcer bed. Minimal deformation of the lumen was observed. Histopathological assessment after surgical resection at a later date revealed thinned submucosa with minimal fibrosis of the ESD scar. This case demonstrated the effect of dexamethasone on the healing process of the artificial ulcer. Dexamethasone can be potentially useful for prevention of postoperative stricture, which is a major complication of esophageal ESD.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.affiliation: Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan. mtfujish-kkr@umin.ac.jp.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.affiliation: Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Minatsuki
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Kousuke
authors.initials: K
authors.lastname: Hirano
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Niimi
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Goto
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Nobutake
authors.initials: N
authors.lastname: Yamamichi
authors.affiliation: Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Seto
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
keywords: ESD; Esophagus; Steroid; Stricture