[Barrett esophagus with severe epithelial dysplasia--always surgery? A case report]

A 57 year-old patient presented with a Barrett's epithelium over the length of 18 cm. We found the typical functional changes of acid reflux and hypomotility in the distal esophagus. There was a history of chemotherapy for seminoma 30 years ago. Because of the repeated finding of severe dysplasia surgery was proposed. The patient died in the postoperative period with the signs and symptoms of pulmonary embolism. There was no invasive tumor found in the resected part of the esophagus. Main aspects of the etiology and histological characterism of Barrett's esophagus and the indication for surgery in cases with severe dysplasia are discussed.