Endoscopy 2025; 57(S 02): S499-S500
DOI: 10.1055/s-0045-1806291
Abstracts | ESGE Days 2025
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A case of cardio-esophageal adenocarcinoma in liver cirrhosis: Case Report

S Taci
1   UNIVERSITY HOSPITAL CENTER MOTHER TEREZA, Gastrohepatology, Tiranë, Albania
,
H Kolani
2   UNIVERSITY HOSPITAL CENTER MOTHER TEREZA, Department of General Surgery, Tiranë, Albania
,
P Kapo
3   Hygeia Hospital Tirane, Albania, Tirana, Albania
,
A Bruci
4   REGIONAL MEMORIAL HOSPITAL, Fier, Albania
,
F Kola
5   Mother Teresa Hospital, Tirana, Albania
,
E Beqja
5   Mother Teresa Hospital, Tirana, Albania
,
N Luli
6   REGIONAL HOSPITAL SHKODER, Shkoder, Albania
,
E Sadiku
1   UNIVERSITY HOSPITAL CENTER MOTHER TEREZA, Gastrohepatology, Tiranë, Albania
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Patients with liver cirrhosis have a higher incidence of esophageal malignancies and carry also high surgical risks and postoperative complications.

Case report A 54-year-old male was admitted to our department with hematemesis and melena. He had been diagnosed with Child – Pugh grade A cirrhosis and esophagogastric varices due to alcohol use, 3 years ago. Upper endoscopy revealed grade 3 esophageal varices and gastric varices. Band ligation was performed figure1. Follow up endoscopy, after 4 weeks, showed grade 2 esophageal varices, gastric varices GOV2, and a nodular lesion in cardias Figure2. Histology revealed moderately differentiated adenocarcinoma, grade 2. Computed tomography (CT) showed perigastric and supradiaphragmatic lymph nodes. The patient underwent distal esophagectomy according to the Ivor-Lewis procedure. He developed ascites and jaundice during hospitalization and was discharged after 10 days in good condition [1] [2] [3].

Discussion Esophageal malignancies are more prevalent in cirrhotic patients due to alcohol, and tobacco use. Patients with esophageal carcinoma and concomitant liver cirrhosis have high risk of mortality and morbidity following esophagectomy. However, esophagectomy can be performed for certain esophageal cancer patients with concomitant liver cirrhosis, mostly in Child class A patients, with acceptable operative risks and a meticulous perioperative care.

Conclusion This case highlights the difficulty in the treatment of esophageal carcinoma in patients with cirrhosis. Regardless of so many controversies, esophagectomy can be performed in Child Class A patients, after a careful preoperative evaluation.



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Artikel online veröffentlicht:
27. März 2025

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