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Lateral Spreading Tumor Arising in an Interposed Colonic Segment.

Carolina Simões¹, Miguel Moura¹, Carlos Noronha Ferreira¹

¹Department of Gastroenterology and Hepatology, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, Lisboa, Portugal.

ACG Case Reports Journal

|December 14, 2019

Summary

A rare case of colon adenoma developed 30 years after esophageal reconstruction using colonic interposition. This finding highlights a potential long-term complication of this surgical procedure.

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Area of Science:

Gastroenterology
Surgical Oncology
Gastrointestinal Pathology

Background:

Esophageal strictures often require surgical intervention, with colonic interposition being a historical method for esophageal reconstruction.
Long-term surveillance of patients undergoing such procedures is crucial for detecting late complications.

Observation:

A 57-year-old woman presented with dysphagia 30 years post-esophagectomy with colonic interposition.
Endoscopy revealed a 40 mm granular lateral spreading tumor within the colonic segment.
The lesion was successfully treated with endoscopic mucosal resection.

Findings:

Histological examination confirmed the tumor as a tubular adenoma with low/high-grade dysplasia.
This represents a rare late complication following colonic interposition for esophageal reconstruction.

Implications:

The development of adenoma in colonic interposition grafts warrants consideration in long-term patient follow-up.
This case underscores the importance of endoscopic surveillance for detecting neoplastic changes in reconstructed esophageal segments.
Further research may be needed to establish optimal surveillance protocols for these patients.