Multidisciplinary approach and diagnostic difficulties in esophageal adenocarcinoma: a case report

Esophageal adenocarcinoma is one of the most common gastrointestinal cancers. Esophagogastroduodenoscopy (EGD) with biopsy and immunohistochemistry are used to detect neoplasm at an early stage. Definitive diagnosis requires not only highly specialized equipment, but also depends on the skills of endoscopist and pathologist. We report a case of a 35-year-old man with progressive dysphagia caused by gastroesophageal cancer. Numerous EGD studies, computed tomography and barium X-ray swallow revealed an extensive esophageal lesion, but pathomorphologic examinations did not confirm malignancy within a year. The results of histological studies showed pyloric gland adenoma, adenoma from parietal or oncocytic cells with high-grade dysplasia. EGD with targeted biopsy at the specialized center confirmed the tumor malignancy. This clinical case demonstrates the importance of clinical symptoms and additional instrumental methods for making a definitive diagnosis if the biopsy results are ambiguous.