English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

of the esophagus is squamous cell carci− noma. The majority of adenocarcinomas of the esophagus originate in the esopha− gogastric junction, Barrett’s esophagus, or ectopic gastric mucosa [1]. Adenocarcino− ma arising in a submucosal gland of the esophagus beneath the squamous epithe− lium is rare [2]. A 43−year−old woman with an esophageal submucosal lesion about 1 cm in size, lo− cated 24 cm from the incisors (l" Fig. 1 a), underwent endoscopic ultrasonography that revealed an isoechoic lesion about 0.5 cm in size over the deep mucosal and submucosal layers of the esophageal wall (l" Fig. 1 b). The patient underwent endoscopic mu− cosal resection using the cap method (EMRC) without complications (l" Fig. 1 c). The resected specimen measured 1  0.5  0.5 cm. Microscopically, a sub− mucosal tumor composed of distorted tubular glands with an infiltration growth pattern was noted. The tumor was confined to the submucosa without involvement of either overlying epithe− lium or muscularis propria. Diagnosis was a tubular adenocarcinoma arising in the submucosal glands (l" Fig. 2). After an explanation of the risks of possi− ble aggressive behavior of adenocarcino− ma of the esophagus, the patient still re− fused surgery or adjuvant radiation ther− apy. To date (18 months of follow−up), there has been no evidence of recurrence or metastasis. There were some concerns: increased depth of tumor invasion increases the risk of lymph node metastases [3], and endoscopic therapy for tumors with sub− mucosal invasion may overlook this risk. Therefore, there are still debates about endoscopic mucosal resection as a treat− ment for early esophageal cancer [4, 5]. In our reported case, the adenocarcinoma arose in the submucosal gland, not in epi− thelium. The definition of this tumor as “early stage” may be somewhat contro− versial. In this case, we considered that local treatment alone was not contraindicated, since both endoscopic image and patho− logical section showed complete resec− tion, and endoscopic ultrasonography and chest CT scan gave no evidence of lymph node metastasis.

Early adenocarcinoma originating in submucosal gland of thoracic esophagus presenting as submucosal tumor