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An 83−year−old woman presented with a history of dysphagia and a 10−kg weight loss over a 6−month period. On endosco− py, multiple glassy−looking polyps were seen in the upper and middle thirds of the esophagus (Figure 1 a). No Barrett s metaplasia was observed in the distal esophagus. Biopsy specimens taken from the polyps revealed multifocal adenocar− cinoma originating from the ducts of esophageal mucus glands. The lesions showed extensive mucus production and were located mainly in the submucosal layer, undermining non−neoplastic squa− mous epithelium (Figure 1 b). There were micropapillary in−situ formations as well as foci of overt, infiltrating, poorly differ− entiated cancer (Figure 1 c). The patient refused further evaluation and therapy.

Multifocal primary salivary-type adenocarcinoma of the esophagus