AFP-producing adenocarcinoma arising from ectopic gastric mucosa in the cervical esophagus treated with endoscopic submucosal dissection

Abstract

An 87-year-old man with dysphagia was diagnosed with esophageal adenocarcinoma. Endoscopic examination revealed a 15-mm, erythematous elevated lesion in the cervical esophagus continuous with the ectopic gastric mucosa. Neither computed tomography nor 2-fluoro-2-deoxy-D-glucose-positron emission tomography revealed signs of lymph node or distant metastasis. Owing to the patient's advanced age, endoscopic submucosal dissection (ESD) under general anesthesia was performed for local control. Immunohistochemical examination revealed sal-like protein 4 (+), alpha-fetoprotein (AFP) (+), glypican-3 (+), and hepatocyte paraffin 1 (-), confirming the diagnosis of AFP-producing adenocarcinoma. This report describes an extremely rare case of ESD for AFP-producing adenocarcinoma arising from the ectopic gastric mucosa.