Endoscopic resection of an adenoma arising in cervical inlet patch: a case report

Cervical inlet patch refers to heterotopic gastric mucosa located in the proximal esophagus, which can be congenital or acquired and has a rare potential for neoplastic transformation. We report a rare case of a tubulovillous adenoma with high-grade dysplasia arising from an inlet patch. A 67-year-old male presented with a complaint of nighttime acid regurgitation and throat discomfort. Endoscopic examination revealed a 20 mm sessile polyp at 16-18 cm from the incisors, arising in an heterotopic gastric mucosa. Following comprehensive diagnostic workup including endoscopic ultrasound and computed tomography, endoscopic mucosal resection was performed. Histopathological examination confirmed a tubulovillous adenoma with high-grade dysplasia developed on gastric heterotopic mucosa with associated intestinal metaplasia. Complete resection was achieved, and follow-up endoscopy at 12 months showed no recurrence with complete resolution of symptoms. This case highlights the neoplastic potential of cervical inlet patches and demonstrates the efficacy of endoscopic resection as a definitive treatment modality for such lesions.