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Two cases of dysplasia in heterotopic gastric mucosa in upper oesophagus
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Abstract
By presenting 2 cases of dysplasia within the macroscopically typical HGMUE in this paper we would like to bring up the important problem of potential neoplastic transformation of this congenital change.
Case study
1. An endoscopic examination carried out on a 65 year old female patient, complaining of a recurrence of heavy heartburn, discomfort in the epigastrum and other ailments of a dyspeptic character, revealed a slightly collapsed smooth area of reddened and shiny mucosa sized app. 20 × 20 mm, with well-marked borders, suspected to be HGMUE. Results of histopathological examination of the specimen collected in the upper oesophagus disclosed a focus of low grade dysplasia in the heterotopic gastric mucosa.
2. The second patient, also a 65 year old female, was treated for esophagitis erosiva (Los Angeles). A supervisory endoscopic examination carried out after 2 weeks of intensive conservative treatment, introduced with lansoprazole in a dose 2 × 30 mg, revealed almost completely healed erosions. However, it also revealed two well-defined, shiny, smooth and reddened areas of mucosa, different comparing to their surroundings, just below the upper oesophageal sphincter during a slow retraction of the endoscope. Results of the histopathological examination of the bifocal change of the mucosa revealed two ectopies. One of them contained a focus of low grade dysplasia.
Conclusion: Despite the fact, that most HGMUE lesions remain asymptomatic anomalies, the two above-presented cases of patients with dysplasia in heterotopic gastric mucosa indicate the possibility of neoplastic transformation.
Abstract
By presenting 2 cases of dysplasia within the macroscopically typical HGMUE in this paper we would like to bring up the important problem of potential neoplastic transformation of this congenital change.
Case study
1. An endoscopic examination carried out on a 65 year old female patient, complaining of a recurrence of heavy heartburn, discomfort in the epigastrum and other ailments of a dyspeptic character, revealed a slightly collapsed smooth area of reddened and shiny mucosa sized app. 20 × 20 mm, with well-marked borders, suspected to be HGMUE. Results of histopathological examination of the specimen collected in the upper oesophagus disclosed a focus of low grade dysplasia in the heterotopic gastric mucosa.
2. The second patient, also a 65 year old female, was treated for esophagitis erosiva (Los Angeles). A supervisory endoscopic examination carried out after 2 weeks of intensive conservative treatment, introduced with lansoprazole in a dose 2 × 30 mg, revealed almost completely healed erosions. However, it also revealed two well-defined, shiny, smooth and reddened areas of mucosa, different comparing to their surroundings, just below the upper oesophageal sphincter during a slow retraction of the endoscope. Results of the histopathological examination of the bifocal change of the mucosa revealed two ectopies. One of them contained a focus of low grade dysplasia.
Conclusion: Despite the fact, that most HGMUE lesions remain asymptomatic anomalies, the two above-presented cases of patients with dysplasia in heterotopic gastric mucosa indicate the possibility of neoplastic transformation.
Keywords
ectopic (heterotopic) gastric mucosa in the upper oesophagus; endoscopy


Title
Two cases of dysplasia in heterotopic gastric mucosa in upper oesophagus
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
112-119
Published online
2007-06-27
Page views
5844
Article views/downloads
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Bibliographic record
Chirurgia Polska 2007;9(2):112-119.
Keywords
ectopic (heterotopic) gastric mucosa in the upper oesophagus
endoscopy
Authors
Tomasz Operchalski
Wojciech Latos
Bogna Drozdowska
Karolina Sieroń-Stołtny
Aleksander Sieroń