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Case Reports
. 2018 Mar 7;24(9):1056-1062.
doi: 10.3748/wjg.v24.i9.1056.

Four cancer cases after esophageal atresia repair: Time to start screening the upper gastrointestinal tract

Floor Wt Vergouwe  1 , Madeleine Gottrand  2 , Bas Pl Wijnhoven  3 , Hanneke IJsselstijn  4 , Guillaume Piessen  5 , Marco J Bruno  1 , René Mh Wijnen  4 , Manon Cw Spaander  6
Affiliations
Case Reports

Four cancer cases after esophageal atresia repair: Time to start screening the upper gastrointestinal tract

Floor Wt Vergouwe et al. World J Gastroenterol. .

Abstract

Esophageal atresia (EA) is one of the most common congenital digestive malformations and requires surgical correction early in life. Dedicated centers have reported survival rates up to 95%. The most frequent comorbidities after EA repair are dysphagia (72%) and gastroesophageal reflux (GER) (67%). Chronic GER after EA repair might lead to mucosal damage, esophageal stricturing, Barrett's esophagus and eventually esophageal adenocarcinoma. Several long-term follow-up studies found an increased risk of Barrett's esophagus and esophageal carcinoma in EA patients, both at a relatively young age. Given these findings, the recent ESPGHAN-NASPGHAN guideline recommends routine endoscopy in adults born with EA. We report a series of four EA patients who developed a carcinoma of the gastrointestinal tract: three esophageal carcinoma and one colorectal carcinoma in a colonic interposition. These cases emphasize the importance of lifelong screening of the upper gastrointestinal tract in EA patients.

Keywords: Adenocarcinoma; Barrett’s esophagus; Esophageal atresia; Esophageal cancer; Screening; Squamous cell carcinoma.

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Conflict of interest statement

Conflict-of-interest statement: All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Chest computed tomography scan (CT scan) (case 1, tumor 2) demonstrating a tumor mass in the cervical native esophagus with suspected tumor invasion in the left thyroid gland.
Figure 2
Figure 2
Findings at upper endoscopy and chest computed tomography scan (CT scan) (case 2). A: Upper endoscopy revealing a stenotic ulcerative tumor in the proximal esophagus, 22-29 cm from incisors. Histological examination of esophageal biopsies confirmed the diagnosis esophageal squamous cell carcinoma. B: Chest CT scan showing a tumor mass in the proximal esophagus with suspected tumor invasion in the trachea.
Figure 3
Figure 3
Initial findings at positron emission tomography-computed tomography scan (PET-CT scan) (case 3), showing PET-positive lesion in the distal esophagus without metastasis.
Figure 4
Figure 4
Initial findings at positron emission tomography-computed tomography scan (PET-CT scan) (case 4). A: Chest CT scan image with a circumferential wall thickening of the thoracic colonic interposition over a length of 10 cm, not clearly separated from the thyroid and left brachiocephalic vein. Locoregional suspected lymph nodes (< 1 cm). B: PET-CT scan showing a PET-positive lesion in the thoracic colonic interposition. No PET-positive lesions or lymph nodes.
See this image and copyright information in PMC

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