Clinical, endoscopic and histopathological observation of a rare case of esophageal submucosal gland duct adenoma: A case report.

Abstract

Background: Esophageal submucosal gland duct adenoma (ESGDA) is very rare, and easily diagnosed as adenocarcinoma.

Case summary: A 70-year-old man presented with abdominal discomfort and intermittent dull pain during swallowing for 10 days. Digestive endoscopy revealed a polypoid bulge at the esophago-gastric junction, which was resected by endoscopic submucosal dissection (ESD). Routine pathological examination showed intestinal metaplasia of the glandular epithelium on the mucosal surface, with serous tumor-like complex glands in the submucosa which showing significant hyperplasia. This initially diagnosis was early gastric adenocarcinoma. However, we still observed a few points that did not meet the criteria for cancer such as lack of malignant features. Following multidisciplinary discussion and consultation with the experienced specialist pathologists, we finally diagnosed the lesion as a rare ESGDA by further immunohistochemistry. The follow-up examination results for the patient were satisfactory, with no evidence of tumor recurrence. And we summarize the ESGDAs reported in the literature, aiming to enhance understanding of this tumor type.

Conclusion: ESGDA is a benign tumor that can be cured by ESD. Accurate diagnosis can prevent unnecessary extensive therapeutic interventions.