A case report of Barrett's esophageal adenocarcinoma in a young adult aged 20 years

Abstract

In Japan, the prevalence of Barrett's esophageal adenocarcinoma (BEA) has recently increased owing to a decrease in the number of patients with Helicobacter pylori infection, westernization of the diet, and an increase in obesity prevalence. However, BEA in patients in their 20s is extremely rare. Our patient was a 20-year-old Japanese woman with chief complaints of vomiting and nausea. Esophagogastroduodenoscopy was performed to investigate the cause of vomiting, and a raised lesion was found in the gastroesophageal junctional zone. In the magnified observation, the mucosal pattern of the lesion was partially invisible, and the vascular pattern was irregular; the lesion was diagnosed based on the Japan Esophageal Society classification for Barrett's esophagus -related superficial neoplasia. Endocytoscopic observations revealed a highly irregular glandular structure. Computed tomography showed no distant metastasis. Based on these results, we diagnosed BEA as short-segment Barrett's esophagus and performed an endoscopic submucosal dissection. The pathological diagnosis was pT1a-DMM. It was a well-differentiated adenocarcinoma and was treated with curative resection.

BEA is extremely rare in young adults in their 20s. Nonetheless, appropriate surveillance is required for patients with multiple risk factors, including obesity and exposure to acid and bile resulting from persistent vomiting.