ethamolin and Adenocarcinoma

Currently, there is little report of treatment strategy for early gastric cancer (EGC) on gastric fundal varices (GFVs), because controlling GFVs was more challenging than controlling gastric cardiac varices associated with esophageal varices. We first report effective endoscopic treatment of EGC on GFVs of a 77-year-old man with Child-B cirrhosis. Endoscopic ultrasound and multidetector-row computed tomography studies revealed intramucosal EGC on variceal components, supplied from posterior gastric vein and drained to subphrenic vein without gastrorenal shunt. With informed consent, we performed endoscopic submucosal dissection (ESD) after eradication of GFVs by endoscopic injection sclerotherapy (EIS). Histologic assessment revealed curability of ESD and inflammation and fibrosis around EIS site. Thereafter, no recurrence and complication had occurred. To avoid life-threatening bleeding from GFVs, we achieved complete resection by ESD under direct visualization of submucosa after eradication of GFVs by EIS based on the examination of hemodynamics and local relationship between EGC and GFVs.

Topics: Adenocarcinoma; Aged; Combined Modality Therapy; Cyanoacrylates; Dissection; Drug Therapy, Combination; Esophageal and Gastric Varices; Gastric Fundus; Gastric Mucosa; Gastroscopy; Humans; Injections, Intralesional; Iopamidol; Male; Oleic Acids; Sclerosing Solutions; Sclerotherapy; Stomach Neoplasms

In the last decade, several cases of patients with esophageal varices treated with endoscopic sclerotherapy who posteriorly developed carcinoma of the gastroesophageal junction have been reported in the literature. This may only be a coincidence, although the existence of an undemonstrated relationship direct cannot be discarded. The case of a patient diagnosed with alcoholic liver cirrhosis with portal hypertension and esophageal varices who underwent several sessions of endoscopic sclerotherapy with ethanolamine oleate is presented. During follow-up dysphagia was observed due to adenocarcinoma of the lower third of the esophagus. Carcinoma of the esophagus should be taken into account as a rare diagnostic possibility in a patient with dysphagia of recent appearance with a history of esophageal varix sclerotherapy.

Topics: Adenocarcinoma; Aged; Biopsy; Esophageal and Gastric Varices; Esophageal Neoplasms; Esophageal Stenosis; Esophagogastric Junction; Esophagus; Humans; Male; Oleic Acids; Prosthesis Implantation; Sclerosing Solutions; Sclerotherapy; Time Factors