Case of Adenocarcinoma with Gastric Diverticulum Arising in Barrett Esophagus

Hisashi Usuki, Masakazu Murakami, Shokichi Komatsubara, Shigeru Teramoto, Seiji Kawasaki*, Toshiki Misumi*, Yoshiro Morokoshi*, Masahiko Yamamoto*, Keizo Kawai*, Masami Ono*

The Second Department of Surgery, Okayama University Medical School
*The Department of Surgery, Himeji St. Mary's Hospital

A case of adenocarcinoma arising in Barrett's esophagus whose serum carcinoembryonic antigen (CEA) was pathologically high is reported. A 60-year-old man was admitted with a complaint of abdominal fullness. A large gastric diverticulum was pointed out 9 years earlier. Radiologic examination revealed a tumor in the lower esophagus, but no finding of hiatal hernia. The serum CEA level was elevated to 44.7 ng/ml. A subtotal esophagectomy with wide lymph node dissection and antesternal esophagogastrostomy was performed. The gross specimen contained a tumor with ulceration. Microscopically the squamous epithelium of the lower esophagus was replaced by columnar epithelium. The moderately differentiated adenocarcinoma was almost surrounded by this epithelium. The serum CEA level had decreased to 26.1 ng/ml 4 days after the operation. But, it increased again when the metastatic lesion was found.

Key words
Barrett esophagus, adenocarcinoma

Reprint requests
Hisashi Usuki The Second Department of Surgery, Okayama University Medical School JAPAN

Accepted
November 20, 1991

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