A CASE OF MUCOSAL ADENOCARCINOMA IN THE LOWER ESOPHAGUS, ARISING FROM CARDIAC GLANDS

Abstract

A 52-year-old man was admitted to our hospital in order to have endoscopic mucosal resection (EMR) for colorectal polyps. He underwent upper gastrointestinal endoscopy because of epigastric pain. Endoscopic picture showed a reddish depressed lesion, 10mm in size, in the distal esophagus adjacent to the esophagogastric junction (EGJ). This lesion was biopsied and pathologically diagnosed as adenocarcinona. EMR was performed for this lesion. Histological examination revealed moderately differentiated tubular adenocarcinoma, involving the lamina propria mucosae (m₃), lymphatic permeation (ly₁), and no venous permeation (v₀). As lymphatic permeation was detected, esophagectomy was performed. On histological examination of the surgically resected specimen, carcinoma cells were limited to the mucosal layer, however, there was no metastasis to the lymph nodes. Early mucosal adenocarcinoma in the distal esophagus adjacent to the EGJ is vary rare. It was presumed that adenocarcinoma developed from cardiac glands in the mucosa of EGJ zone.