A CASE OF SUPERFICIAL BARRETT'S ESOPHAGEAL ADENOCARCINOMA WITH NODAL INVOLVEMENT DIAGNOSED BY SURGICAL RESECTION AFTER ENDOSCOPIC MUCOSAL RESECTION

Abstract

A 42-year-old man was admitted to the hospital because of epigastralgia in March 2000. Endoscopic examination revealed a 0-IIa+IIc lesion, 15mm in diameter, in a short segment Barrett's esophagus which was extended 2.5cm from the esophago-gastric junction. A histological examination of a biopsy specimen revealed adenocarcinoma. For making the definitive diagnosis, an endoscopic mucosal resection was performed. Pathological findings of the resected specimen were tubular adenocarcinoma, sm2 invasion, with the positive external margins. An extended mediastinal lymph node dissection and an esophagectomy with a reconstruction of the gastric tube were performed. There was no residual tumor in the esophagus, but two lymph node metastases were present in the mediastinum and abdomen. The status of the lymph node metastasis of superficial adenocarcinoma and the depth of tumor invasion have not been clarified as yet. In this case, D2 lymphadenectomy was required as curative operation for superficial esophageal adenocarcinoma.