title: Case of Barrett's adenocarcinoma with marked endoscopic morphological changes in Barrett's esophagus over a long follow-up period of 15 years.
abstract: The natural history of Barrett's esophagus (BE) is unclear. We herein describe a case of Barrett's adenocarcinoma (BAC) in which we could closely observe marked morphological changes in BE over a long follow-up period of 15 years. A man in his seventies received routine esophagogastroduodenoscopy (EGD) and was diagnosed as having reflux esophagitis and short-segment BE. The BE gradually became elongated, and BAC was detected 9 years following the initial EGD examination with continued administration of a proton pump inhibitor. We witnessed that BE elongated sporadically over time and mucosal breaks of reflux esophagitis were detectable several years before elongation. The patient underwent endoscopic submucosal dissection for BAC and has been monitored by EGD every year thereafter. These remarkable morphological changes may be representative of the natural history of BE and aid in deciding long-term disease management.
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.|Department of Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Iwaya
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Yamazaki
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Seki
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Ochi
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Hara
authors.affiliation: Endoscopic Examination Center, Shinshu University Hospital, Matsumoto, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Arakura
authors.affiliation: Department of Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Hasebe
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013997:Time Factors
keywords: Barrett's adenocarcinoma; Barrett's esophagus; Barrett's esophagus elongation and proton pump inhibitor; Plus; long follow up