Recurrence of subsquamous dysplasia and carcinoma after successful endoscopic and radiofrequency ablation therapy for dysplastic Barrett’s esophagus

J. K. Lee; R. G. Cameron; K. F. Binmoeller; J. N. Shah; A. Shergill; R. Garcia-Kennedy; Y. M. Bhat

doi:10.1055/s-0032-1326419

Endoscopy, Table of Contents

Endoscopy 2013; 45(07): 571-574
DOI: 10.1055/s-0032-1326419

Case report/series

Recurrence of subsquamous dysplasia and carcinoma after successful endoscopic and radiofrequency ablation therapy for dysplastic Barrett’s esophagus

Authors

J. K. Lee

¹Department of Medicine and Division of Gastroenterology, VA San Francisco Medical Center and University of California, San Francisco, California, USA
R. G. Cameron

²Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA
K. F. Binmoeller

²Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA
J. N. Shah

¹Department of Medicine and Division of Gastroenterology, VA San Francisco Medical Center and University of California, San Francisco, California, USA

²Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA
A. Shergill

¹Department of Medicine and Division of Gastroenterology, VA San Francisco Medical Center and University of California, San Francisco, California, USA
R. Garcia-Kennedy

²Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA
Y. M. Bhat

¹Department of Medicine and Division of Gastroenterology, VA San Francisco Medical Center and University of California, San Francisco, California, USA

²Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA

Abstract

Barrett’s esophagus with dysplasia is commonly treated with radiofrequency ablation (RFA). Despite its effectiveness, a concern of any ablative technique is the development of subsquamous intestinal metaplasia, which could have potential for future neoplastic progression. To date, 34 cases of subsquamous neoplasia have been described in the literature after various ablation therapies. However, only three cases of subsquamous neoplasia have been reported after successful RFA treatment of dysplastic Barrett’s esophagus. In this case series, we report on four additional cases of subsquamous neoplasia detected after successful endoscopic resection and RFA for neoplastic and dysplastic Barrett’s esophagus. All four patients were treated successfully with endoscopic resection of their recurrent subsquamous neoplastic and dysplastic lesions. This case series highlights the need for continued surveillance following successful treatment of dysplastic Barrett’s esophagus with RFA.

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References

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