A CASE OF EARLY ADENOCARCINOMA EXISTING IN BARRETT'S ESOPHAGUS

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  • 経過観察中に早期食道癌を合併したBarrett食道の1例

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We report a case of early adenocarcinoma existing in Barrett's esophagus which was found during follow-up of its clinical course. A 67-years-old man consulted on our outpatient clinic with a complaint of abdominal discomfort. The initial endoscopic examination showed Barrett's esophagus. Adenocarcinoma was found at the same location 3 years later. An elevated lesion, which was demonstrated at the lower part of the esophagus on barrium meal examination, consisted of well differentiated tubular adenocar-cinoma with endoscopic biopsy. In addition, dye and balloon endoscopies were performed and recognized to be remarkably useful for the diagnosis of small cancerous lesion in the Barrett's epithelium. The surgical specimen showed that lower part of the esophagus was lined by ectopic columnar epithelium with islets of squamous epithelium remained within Barrett's epithelium. Carcinoma was 1.4×1.4 cm in size and cancerous invasion was limited within the submucosa (sm) in which esophageal glands were seen microscopically. Although the etiologic relationship between Barrett's esophagus and esophageal adenocarcinoma remains to be elucidated, 22 reported cases of adenocarcinoma existing in the Barrett's epithelium including our case were reviewed.

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