A 44-year-old man was referred to our hospital for therapy for an esophageal hemangioma that had increased remarkably in size over three years of endoscopic follow-up. Although the patient had no history of dysphagia or hematemesis, prophylactic removal of the tumor was planned to prevent hemorrhage. The hemangioma was treated successfully by two rounds of endoscopic injection sclerotherapy (EIS) using 5% monoethanolamine oleate. Only mild chest pain was noted during therapy.
Esophageal hemangioma is a rare disease that may cause bleeding or difficulty eating. Surgical resection, endoscopic mucosal resection, endoscopic submucosal dissection, and laser therapy have all been reported as treatment measures for these lesions. We opted for EIS in the present case because of its low invasiveness and ability to treat lesions protruding from the esophageal wall. Blood flow volume and the precise location of the tumor in the esophageal wall should be evaluated by imaging examinations when deciding on the treatment for esophageal hemangioma.
In 2011, mucinous bronchioloalveolar carcinoma was reclassified as invasive mucinous adenocarcinoma, mucinous adenocarcinoma in situ, and mucinous minimally invasive adenocarcinoma. A part of the invasive mucinous adenocarcinoma of the lung differentiates to gastric mucous cells, and we term this type of carcinoma gastric-like invasive mucinous adenocarcinoma. However, treatment approaches have not yet been established.
An 84-year-old Japanese male visited our hospital because of multiple consolidations and ground-glass opacity on his chest computed tomography. Surgical biopsy of the right lung ground-glass opacity was performed, and it was diagnosed as gastric-like invasive mucinous adenocarcinoma by immunohistochemical analysis. Treatment with gemcitabine and pemetrexed was quite effective, and the radiologic response was complete. We suggest that it is meaningful to determine whether the diagnosis of gastric-like invasive mucinous adenocarcinoma is correct because this may indicate a favourable response to the anticancer drug gemcitabine.