Endoscopic Submucosal Dissection for Esophageal Squamous Cell High-grade Dysplasia in a Patient with Plummer Vinson Syndrome

IF 0.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Endoscopy Pub Date : 2022-12-23 DOI:10.1055/s-0042-1759510

G. Patil, Amol Vadgaonkar, A. Dalal, Sanil Parekh, Animesh Shah, Poorva Haridas, P. Gupte, Sehajad Vora, A. Maydeo

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引用次数: 0

Abstract

Abstract A 35-year female with Plummer Vinson syndrome (PVS) presented with a history of progressive dysphagia over six months, not responding to iron therapy and endoscopic dilatations. Her upper gastrointestinal endoscopy showed a post-cricoid web dilated using a Savary-Gilliard dilator. On NBI, a long segment circumferential lesion with abnormal microvascular architecture was noted in the mid esophagus. Biopsy showed high-grade dysplastic squamous epithelium. The patient underwent minimally invasive, circumferential endoscopic submucosal dissection (ESD) and received oral prednisolone to prevent stricture formation. Resected margins were free of dysplasia. At follow-up there was no evidence of recurrence or stricture formation. To our knowledge, this is the first case of PVS with squamous proliferation with high-grade dysplasia that was successfully treated with circumferential ESD. Screening endoscopy helps in the downstaging of early cancer, and timely intervention helps to treat this with a minimally invasive approach like ESD.

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Plummer-Vinson综合征患者食管鳞状细胞高度发育不良的内镜黏膜下解剖

摘要：一名患有Plummer-Vinson综合征（PVS）的35岁女性，有6个月以上的进行性吞咽困难史，对铁治疗和内镜扩张没有反应。她的上消化道内窥镜检查显示，使用Savary Gilliard扩张器扩张了环状软骨后的网状物。NBI检查发现，食管中段有一个长段周向病变，微血管结构异常。活检显示高度增生异常鳞状上皮。患者接受了微创环向内镜黏膜下剥离术（ESD），并接受了口服泼尼松以防止狭窄形成。切除的边缘没有发育不良。在随访中，没有复发或狭窄形成的证据。据我们所知，这是第一例PVS伴鳞状增生伴高度发育不良的病例，该病例通过环向ESD成功治疗。筛查内窥镜检查有助于降低早期癌症的分期，及时干预有助于通过ESD等微创方法治疗。

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来源期刊

Journal of Digestive Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

自引率

28.60%

发文量

审稿时长

22 weeks

期刊介绍： The Journal of Digestive Endoscopy (JDE) is the official publication of the Society of Gastrointestinal Endoscopy of India that has over 1500 members. The society comprises of several key clinicians in this field from different parts of the country and has key international speakers in its advisory board. JDE is a double-blinded peer-reviewed, print and online journal publishing quarterly. It focuses on original investigations, reviews, case reports and clinical images as well as key investigations including but not limited to cholangiopancreatography, fluoroscopy, capsule endoscopy etc.