Second primary Barrett's adenocarcinoma after 19 years

Because long survival after resection of esophageal carcinoma is uncommon, second esophageal cancers are rare. We report the case of a patient in whom adenocarcinoma developed within residual Barrett's esophagus 19 years after esophagectomy for stage IIb Barrett's adenocarcinoma. Implications relative to the type of operation and adequacy of resection are discussed. Long-term survival after Barrett's adenocarcinoma may occur more often if surveillance protocols achieve their aim. Questions concerning the management of such patients are identified.