Barrett's Adenocarcinoma Detected after Endoscopic Balloon Dilation, Report of Case

A 64-year-old female, who had a history of total gastrectomy with esophago-duodenostomy for early gastric cancer at the age of 50 years, was admitted to our hospital with a complaint of dysphagia. Her upper esophagus exhibited a circular narrowing, where there was no evidence of malignancy on biopsy specimens. Consequent to endoscopic balloon dilation, an adenocarcinoma presenting irregularly shaped elevated mucosa was recognized in the middle esophagus. The patient therefore underwent subtotal esophagectomy. On histologic examination, resected esophagus 10 cm in length was extensively covered by columnar epithelium with severe intestinal metaplasia, corresponding to the specialized columnar epithelium of Barrett's esophagus. In addition, moderate to poorly differentiated adenocarcinoma limited to the submucosa without lymph node involvement was identified in the area of the Barrett's esophagus.