胃入口补片(GIP)是一种异位胃粘膜病变,通常出现在宫颈食管,很少引起食管腺癌(EAC)。据我们所知,这是首例GIP衍生的EAC使用多学科治疗方法成功治疗.一名64岁的男子被转诊到胃肠外科,金泽大学医院(金泽,日本)用于手术治疗先前接受过诱导化疗治疗的GIP引起的难治性复发性宫颈EAC,确定性放化疗和光动力疗法(PDT)。食管胃十二指肠镜检查显示,宫颈食管GIP部位有狭窄肿瘤,粘膜下肿瘤在胸食管肛门侧怀疑有多个壁内转移。在最后一次PDT手术后4个月,该患者接受了机器人辅助的胸腔镜食管切除术,喉咽切除术和颈淋巴结切除术作为根治性抢救手术。术后辅助化疗口服替加氟/吉马拉西/奥曲拉西(口服5-氟尿嘧啶前药)1年后;目前,患者在手术后3年没有复发。
A gastric inlet patch (
GIP) is an ectopic gastric mucosal lesion usually arising at the cervical esophagus that may rarely cause esophageal adenocarcinoma (EAC). To the best of our knowledge, this is the first
case of a
GIP-derived EAC that was successfully treated using a multidisciplinary treatment approach. A 64-year-old man was referred to the Department of Gastrointestinal Surgery, Kanazawa University Hospital (Kanazawa, Japan) for surgical treatment of refractory recurrent cervical EAC derived from
GIP who had previously been treated with induction chemotherapy, definitive chemoradiotherapy and photodynamic therapy (PDT). Esophagogastroduodenoscopy revealed a stenotic tumor at the
GIP site in the cervical esophagus and submucosal tumors with suspected multiple intramural metastases in the anal side of the thoracic esophagus. The patient underwent robot-assisted thoracoscopic esophagectomy with laryngopharyngectomy and cervical lymphadenectomy as radical salvage surgery 4 months after the last PDT procedure. After postoperative adjuvant chemotherapy using oral administration of tegafur/gimeracil/oteracil (oral 5-fluorouracil prodrug) for 1 year; at present, the patient is alive without recurrence 3 years after the operation.