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CC BY 4.0 · Endoscopy 2024; 56(S 01): E611
DOI: 10.1055/a-2346-4863
E-Videos

Endoscopic submucosal dissection for resection of giant adenoid cystic carcinoma of the esophagus

Yu Xia
1   The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Jian Li 
1   The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Guanzhang Wen
1   The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Qiqi Zhang
1   The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Jingjing Yao
1   The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
,
Zhiqiang Zhang
1   The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
› Institutsangaben
Gefördert durch: The Technology Innovation Team (Tianshan Innovation Team) Project 2022TSYCTD0018
Gefördert durch: State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia SKL-HIDCA-2021-51
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A 53-year-old man presented with progressive dysphagia and retrosternal pain. A gastroscope revealed a giant pronounced protrusion lesion with a thick pedicle in the lower esophagus measuring approximately 60 × 25 mm. Further refinement via computed tomography (CT) indicated an occupying lesion in the distal esophagus with no evidence of metastatic disease present; this led to the suggestion of performing an endoscopic resection

The surgery was performed under general anesthesia with endotracheal intubation ([Video 1]) involving submucosal injection of saline with diluted methylene blue, and the use of a DualKnife for the endoscopic mucosal dissection. Hemostatic forceps were employed intraoperatively to control bleeding. Postoperative treatment with sucralfate suspension was given for 4 weeks to promote mucosal recovery. Histology revealed a solid-type adenoid cystic carcinoma with ulceration affecting the submucosa with clean margins obtained from the resection.


Qualität:
Successful endoscopic resection of a giant adenoid cystic carcinoma of the esophagus.Video 1

At a 3-month follow-up, the patientʼs sensation of a foreign body during ingestion had resolved completely. Gastroscopy indicated white uniform scarring in the esophagus without luminal narrowing or residual tumor, and a repeat CT scan showed no signs of disease recurrence or metastasis.

Adenoid cystic carcinoma is common in salivary glands but rare in the esophagus, with the chief symptom being progressive dysphagia [1]. There is no standard treatment method established for esophageal adenoid cystic carcinoma, with radical resection being the preferred therapeutic option [2]. Postoperative radiotherapy is advised if the surgical margins are positive. Herein, we report a rare case of esophageal adenoid cystic carcinoma detected as a giant esophageal tumor through endoscopic examination and managed with endoscopic submucosal dissection leading to a radical resection without metastasis.

Endoscopy_UCTN_Code_CCL_1AB_2AC

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E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).

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Conflict of Interest

The authors declare that they have no conflict of interest.

  • References

  • 1 Bardou FN, Rivory J, Robert M. et al. Endoscopic features of an adenoid cystic carcinoma of the esophagus: narrow-band imaging and dual focus magnification. Endoscopy 2016; 48: E380-E382
    Thieme ConnectPubMedSuche in Google Scholar
  • 2 Yoshikawa K, Kinoshita A, Hirose Y. et al. Endoscopic submucosal dissection in a patient with esophageal adenoid cystic carcinoma. World J Gastroenterol 2017; 23: 8097-8103
    CrossrefPubMedSuche in Google Scholar

Correspondence

Zhiqiang Zhang, MD
The Second Department of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University
137 Liyushan Road
Urumqi 830054
China   

Publikationsverlauf

Artikel online veröffentlicht:
15. Juli 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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  • References

  • 1 Bardou FN, Rivory J, Robert M. et al. Endoscopic features of an adenoid cystic carcinoma of the esophagus: narrow-band imaging and dual focus magnification. Endoscopy 2016; 48: E380-E382
    Thieme ConnectPubMedSuche in Google Scholar
  • 2 Yoshikawa K, Kinoshita A, Hirose Y. et al. Endoscopic submucosal dissection in a patient with esophageal adenoid cystic carcinoma. World J Gastroenterol 2017; 23: 8097-8103
    CrossrefPubMedSuche in Google Scholar

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