A Case of Intramucosal Adenocarcinoma (pT1a-DMM) of Barrett’s Esophagus with Lymph Node Metastasis

• Published in: The Japanese Journal of Gastroenterological Surgery Vol. 45; no. 11; pp. 1075 - 1082
• Main Authors: Asano, Kouji, Takeuchi, Daisuke, Miyagawa, Shinichi, Suzuki, Akira, Nagaya, Tadanobu, Yoshizawa, Junichi, Koide, Naohiko
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2012
• Subjects: Barrett esophagus; lymph node metastasis; mucosal carcinoma
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.45.1075

A 53-year-old woman complained of heartburn, and esophagogastroduodenoscopy showed a protruding lesion at the esophagogastric junction. The tumor was surrounded by lower esophageal palisading vessels under the columnar epithelium. Pathological analysis of the biopsy samples taken from the tumor showed moderately differentiated adenocarcinoma. Computed tomography showed a lymph node (7 mm in diameter) in the lesser curvature of the stomach, but the lymph node detected on computed tomography had no abnormal uptake in FDG-PET. No distant metastases were detected. We conducted an operation under a diagnosis of adenocarcinoma of Barrett’s esophagus invading the submucosal layer. Histopathological examination of the resected tumor revealed moderately or poorly differentiated adenocarcinoma of Barrett’s esophagus. The tumor invaded the deep muscularis mucosa (pT1a-DMM). Metastasis was observed in the node located in the lesser curvature of the stomach (No. 3a). She has been regularly followed up and has shown no sign of tumor recurrence in the 27 months since surgery.