scholarly journals Aggressive Adenocarcinoma of the Cervical Esophagus: Importance of a Multidisciplinary Approach

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Adedayo Fashoyin ◽  
Gregory Hartig ◽  
William R. Schelman ◽  
Mark Ritter ◽  
Rashmi Agni ◽  
...  
Keyword(s):  
Rare Disease ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Distal Esophagus ◽  
Cervical Esophagus ◽  
Rare Tumor

Adenocarcinoma of the cervical esophagus is a rare tumor, in comparison to adenocarcinoma of the distal esophagus which is on the rise and is often associated with Barrett's esophagus. We present a case of aggressive cervical esophageal adenocarcinoma in a 46-year-old female with no endoscopic or histopathologic evidence of Barrett’s esophagus. We discuss the possible etiology of this tumor and review the treatment options, highlighting the importance of a multidisciplinary approach to the management of this rare disease.

Reflux, Barrett’s Esophagus, and Esophageal Adenocarcinoma After Bariatric Surgery

2022 ◽  
pp. 263451612110683
Author(s):  
Benjamin Medina ◽  
Daniela Molena
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Gastroesophageal Reflux ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Treatment Options ◽  
Effective Treatment Option ◽  
Management Options

We present the case of a patient who developed esophageal adenocarcinoma after a previous laparoscopic sleeve gastrectomy. Bariatric surgery has emerged as the most effective treatment option for weight loss and obesity-related diseases; however, sleeve gastrectomy promotes gastroesophageal reflux and leads to Barrett’s esophagus in a substantial portion of patients. The natural history of Barrett’s esophagus in these patients is unknown, and active surveillance is recommended until the incidence of dysplasia and adenocarcinoma in this population is clarified. Management options for these patients include conversion to Roux-en-Y gastric bypass. Although esophagectomy in patients who have previously undergone sleeve gastrectomy may require an alternative conduit, the remnant stomach can be used in carefully selected patients. Here, we review the different weight loss procedures, their effect on gastroesophageal reflux disease and Barrett’s esophagus, and the treatment options for patients with esophageal cancer after sleeve gastrectomy. We report the use of preoperative coil embolization as a means of vascular preconditioning before successful use of a gastric conduit.

scholarly journals Challenges in Determining the Role of Microbiome Evolution in Barrett’s Esophagus and Progression to Esophageal Adenocarcinoma

2021 ◽  
Vol 9 (10) ◽  
pp. 2003
Author(s):  
Caitlin Guccione ◽  
Rena Yadlapati ◽  
Shailja Shah ◽  
Rob Knight ◽  
Kit Curtius
Keyword(s):  
Microbial Communities ◽  
Barrett’S Esophagus ◽  
Esophageal Adenocarcinoma ◽  
Barrett's Esophagus ◽  
Distal Esophagus ◽  
First Year ◽  
Endoscopic Screening ◽  
Non Invasive ◽  
Main Driver ◽  
Alternative Means

Esophageal adenocarcinoma (EAC) claims the lives of half of patients within the first year of diagnosis, and its incidence has rapidly increased since the 1970s despite extensive research into etiological factors. The changes in the microbiome within the distal esophagus in modern populations may help explain the growth in cases that other common EAC risk factors together cannot fully explain. The precursor to EAC is Barrett’s esophagus (BE), a metaplasia adapted to a reflux-mediated microenvironment that can be challenging to diagnose in patients who do not undergo endoscopic screening. Non-invasive procedures to detect microbial communities in saliva, oral swabs and brushings from the distal esophagus allow us to characterize taxonomic differences in bacterial population abundances within patients with BE versus controls, and may provide an alternative means of BE detection. Unique microbial communities have been identified across healthy esophagus, BE, and various stages of progression to EAC, but studies determining dynamic changes in these communities, including migration from proximal stomach and oral cavity niches, and their potential causal role in cancer formation are lacking. Helicobacter pylori is negatively associated with EAC, and the absence of this species has been implicated in the evolution of chromosomal instability, a main driver of EAC, but joint analyses of microbiome and host genomes are needed. Acknowledging technical challenges, future studies on the prediction of microbial dynamics and evolution within BE and the progression to EAC will require larger esophageal microbiome datasets, improved bioinformatics pipelines, and specialized mathematical models for analysis.

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