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Esophageal Epidermoid Metaplasia Treated With Endoscopic Submucosal Dissection
Karam Al-Bayati1, Gerard Coneys2, Michael Cantor1
1Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
ACG Case Reports Journal
|May 7, 2025
Summary
Esophageal epidermoid metaplasia (EEM) is a rare esophageal condition. Successful endoscopic treatment and PPI therapy led to symptom resolution and no recurrence in a recent case study.
Area of Science:
- Gastroenterology and Oncology
- Esophageal Pathology
- Endoscopic Surgery
Background:
- Esophageal epidermoid metaplasia (EEM) is a rare condition presenting as leukoplakia in the middle-to-distal esophagus.
- It is often associated with dysphagia, gastroesophageal reflux, and potentially high-grade squamous dysplasia or squamous cell carcinoma.
- EEM predominantly affects middle-aged females.
Observation:
- A case report details a 63-year-old woman diagnosed with EEM.
- The diagnosis was confirmed after en bloc endoscopic submucosal dissection of a lesion initially identified as squamous dysplasia.
- The patient presented with symptoms of dysphagia and gastroesophageal reflux.
Findings:
- Post-procedure, the patient was treated with proton pump inhibitors (PPIs).
- A 6-month follow-up revealed no residual squamous dysplasia or EEM recurrence, with biopsies showing normal squamous mucosa.
- The patient remained symptom-free at the 1-year follow-up.
Implications:
- This case highlights the successful management of EEM through endoscopic submucosal dissection and PPI therapy.
- It suggests a favorable prognosis following complete resection and medical management.
- Further research into EEM's pathogenesis and optimal treatment strategies is warranted.
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