Treatment of long-segment Barrett’s adenocarcinoma by complete circular endoscopic submucosal dissection: a case report

• Main Authors: Miki Kaneko, Akira Mitoro, Motoyuki Yoshida, Masayoshi Sawai, Yasushi Okura, Masanori Furukawa, Tadashi Namisaki, Kei Moriya, Takemi Akahane, Hideto Kawaratani, Mitsuteru Kitade, Kousuke Kaji, Hiroaki Takaya, Yasuhiko Sawada, Kenichiro Seki, Shinya Sato, Tomomi Fujii, Junichi Yamao, Chiho Obayashi, Hitoshi Yoshiji
• Format: Article
• Language: English
• Published: BMC 2018-01-01
• Series: BMC Gastroenterology
• Subjects: Barrett esophagus; Adenocarcinoma of esophagus; Endoscopic submucosal dissections; Esophageal stricture
• Online Access: http://link.springer.com/article/10.1186/s12876-018-0743-9
• ISSN: 1471-230X

Abstract Background We present the first description of en bloc endoscopic submucosal dissection (ESD) for total circumferential Barrett’s adenocarcinoma, predominantly of the long-segment Barrett’s esophagus (LSBE), with a 2-year follow-up and management strategies for esophageal stricture prevention. Case presentation A 59-year-old man was diagnosed with LSBE and Barrett’s adenocarcinoma by esophagogastroduodenoscopy (EGD). A 55-mm-long circumferential tumor was completely resected by ESD. Histopathology revealed a well-differentiated adenocarcinoma within the LSBE superficial muscularis mucosa. For post-ESD stricture prevention, the patient underwent an endoscopic triamcinolone injection administration, oral prednisolone administration, and preemptive endoscopic balloon dilatation. Two years later, there is no evidence of esophageal stricture or recurrence. Conclusions ESD appears to be a safe, effective option for total circumferential Barrett’s adenocarcinoma in LSBE.