Case report
Adenocarcinoma of the upper esophagus

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Summary

Glandular heterotopia of the upper esophagus is a congenital abnormality that is frequently discovered during upper digestive tract endoscopy (in 0.26–4.9% of cases), but usually with no malignant potential. Indeed, adenocarcinoma of the upper esophagus related to such lesions is a rare entity. We report here the 27th observation of this rare type of tumor in an 87-year-old man complaining of cervical dysphagia. This adenocarcinoma had developed from an area of gastric heterotopia 3 cm below the upper sphincter of the esophagus. The treatment regimen was based on exclusive radiochemotherapy, which led to a complete endoscopic response at the end of treatment. The patient's symptom-free survival was six months and overall survival was 17 months from diagnosis. This case of a rare tumor of the upper esophagus raises the question of whether the detection and surveillance of this type of heterotopia would be useful and, thus, to be recommended.

Section snippets

Observation

Although glandular heteropia in the upper esophagus is frequently discovered during examination of the upper digestive tract by endoscopy, it is usually a benign finding. Nevertheless, 26 cases of esophageal adenocarcinoma have been reported at this location [1], and this is another report of such an observation.

A 87-year-old man was hospitalized on May 4th, 2009 with upper esophageal dysphagia to solids, lasting for four months, with odynophagia and cough. The patient was a retired teacher and

Discussion

In contrast to lower esophageal adenocarcinoma, carcinoma of the upper esophagus is a rare tumor that, to our knowledge, has only been previously reported in 26 published cases. This type of tumor develops in areas of congenital glandular heterotopia (incomplete replacement of original glandular mucosa during embryogenesis) of gastric type in the upper esophagus, although degeneration appears to be rare [1]. Indeed, finding lesions of glandular metaplasia in the upper esophagus (inlet patch) [2]

Conflict of interest statement

The authors declare no conflict of interest for this work.

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