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So, Kim, Yun, Seok, Hong, Jung, Cha, Lee, Joo, Shin, Park, and Jeoun: A Case of Early Adenocarcinoma at Esophagogastric Junction Treated with Cap-pitted Endoscopic Mucosal Resection
Case Report
The Ewha Medical Journal

The Ewha Medical Journal 2012; 35(2): 124-128.

Published online: 30 September 2012

DOI: https://doi.org/10.12771/emj.2012.35.2.124

A Case of Early Adenocarcinoma at Esophagogastric Junction Treated with Cap-pitted Endoscopic Mucosal Resection

Ye Ri So, Dae Ho Kim, Hyun A Yun, Hwa Young Seok, Seong Hun Hong, Sang Wan Jung, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Hyun Phil Shin, Jae Jun Park, Jung Won Jeoun

Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

Corresponding author: Jae Myung Cha, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, Korea. Tel: 82-2-440-6113, Fax: 82-2-440-6295, drcha@khu.ac.kr

Received 14 June 2012       Accepted 16 July 2012

Copyright © 2012. Ewha Womans University School of Medicine

Abstract

Surgery is the primary treatment for adenocarcinoma originating from the esophagogastric junction. However, many physicians attempt various endoscopic treatments for the cases of early adenocarcinoma and high-grade dysplasia of esophagogastric junction in order to avoid the high risk of complications associated with surgical resection. Recently, there is an increasing tendency to use endoscopic mucosal resection for the management of early esophageal cancer due to low morbidity and mortality rates. We report here on a case of early adenocarcinoma at esophagogastric junction successfully treated with endoscopic mucosal resection.

Keywords: Adenocarcinoma, Endoscopy, Esophagogastric junction

Figures and Tables

Fig. 1
An endoscopic finding. Endoscopy finding shows a 10×15 mm sized polyp, which mimics a sentinel polyp at the esophagogastric junction. White exudate is noted at the top of polyp, however, any ulcer or bleeding is not noted at the surface of polyp.
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Fig. 2
Abdominal computed tomography. It does not show a demonstrable mass or abnormal wall thickening at the esophagogastric junction.
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Fig. 3
Endoscopic findings. (A) Early cancer of esophagogastic junction, which is completely resected with cap-pitted endoscopic mucosal resection. Sufficient amount of normal mucosa (white dot line) is secured under the base of malignant polyp. (B) Endoscopic resection is complete without any remnant lesions.
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Fig. 4
Pathologic findings. The specimen shows moderate differentiated adenocarcinoma (arrows) with negative deep and lateral margins (H&E, ×20). The adenocarcinoma is confined within the mucosal layer, however, focal 500 µm submucosal invasion is noted (arrow heads).
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