Year 2024 / Volume 116 / Number 11
Letter
A case of achalasia associated with early esophageal cancer

653-654

DOI: 10.17235/reed.2024.10177/2023

Ze-Han Chen, Li-Liangzi Guo, Li-Sheng Wang, De-Feng Li, Jun Yao,

Abstract
A 65-year-old man was admitted to our hospital complaining of reflux for more than 20 years. After endoscopy and barium-swallow examination, he was diagnosed with achalasia as well as a squamous cell carcinoma. Therefore, peroral endoscopic myotomy (POEM) combined with endoscopic submucosal dissection (ESD) was performed simultaneously. During the procedure, a mucosal erosion with a clear boundary was shown in the middle segment of the esophagus. ESD was first performed and the lesion was removed en-bloc. Subsequent POEM therapy was performed after marking the left esophageal wall 10cm above the cardia. After submucosal injection, the submucosal plane was created through a length 2cm longitudinal incision, then the muscle was cut a length of 10 cm into the esophagus and 2 cm below the cardia, and finally the incision was closed by clips. Pathological examination revealed high-grade intraepithelial neoplasia of squamous epithelium (carcinoma in situ) with a negative margin. The patient was recovered without complication four days after the procedure. The endoscopy showed perfect healing of the esophageal lesions during two-months follow-up , and the reflux symptom was resolved.
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References
1. Leeuwenburgh I, Scholten P, Alderliesten J, et al. Long-term esophageal cancer risk in patients with primary achalasia: a prospective study. Am J Gastroenterol 2010; 105(10): 2144-9.
2. Sato H, Terai S, Shimamura Y, et al. Achalasia and esophageal cancer: a large database analysis in Japan. J Gastroenterol 2021; 56(4): 360-70.
3. Saftoiu A, Hassan C, Areia M, et al. Role of gastrointestinal endoscopy in the screening of digestive tract cancers in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2020; 52(4): 293-304.
4. Dong T, Jing L, Yang C, et al. Water pressure method combined with magnifying endoscopy for esophageal endoscopic submucosal dissection. Rev Esp Enferm Dig 2023; 115(10): 591-2.
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Chen Z, Guo L, Wang L, Li D, Yao J. A case of achalasia associated with early esophageal cancer. 10177/2023


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Publication history

Received: 15/12/2023

Accepted: 26/12/2023

Online First: 18/01/2024

Published: 11/11/2024

Article Online First time: 34 days

Article editing time: 332 days


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