ENDOSCOPIC SUBMUCOSAL DISSECTION OF A MINUTE INTRAMUCOSAL ADENOCARCINOMA IN BARRETT'S ESOPHAGUS

A 73‐year‐old man with short segmental Barrett's esophagus underwent esophagoscopy, and a slightly depressed, discolored lesion was found on the anterior wall of the lower esophagus. Under a provisional diagnosis of differentiated adenocarcinoma without local lymph node metastasis, endoscopic submucosal dissection (ESD) was carried out. En bloc resection with tumor‐free lateral/basal margins was accomplished without complication. The resected area was 12 × 15 mm in size, whereas the neoplastic lesion was 4 × 4 mm. Histopathological examination confirmed intramucosal well‐differentiated tubular adenocarcinoma without angiolymphatic invasion adjacent to the muscularis mucosae. Repeated esophagoscopy 6 months after ESD showed neither locally recurrent nor metachronous lesions. Considering that Barrett's esophagus is a precancerous condition, one may recommend eradication of both the neoplastic and non‐neoplastic lesion with using ESD.