A CASE OF THE BARRETT'S ADENOCARCINOMAWITH INTRAMUCOSAL SPREAD EXTENDING

Abstract

The patient was a 60-year-old male. The upper esophago-gastro-duodenoscopy was performed for screening purposes. At the esophagogastric junction, a depressed erythematous lesion was found with a diameter of 15 mm. The histopathological diagnosis by biopsy was well-differentiated adenocarcinoma taken with all examination, we valuated the depth of invasion was in the mucosal layer, therefore, ESD was performed. With consideration for esophageal intramucosal invasion, we performed resection with an approximately more than 6 mm margin around the lesion. The histopathological diagnosis indicated that the lesion had subepithelial spread at the oral side of the esophagus. The oral surgical margin was positive and submucosal invasion was observed. Thus, additional resection was performed. Superficial Barrett's adenocarcinoma often spreads submucosal layer, and it is often difficult to diagnose its extent. We report here a case of Barrett's adenocarcinoma with intramucosal spread extending beyond 1 cm.