Esophageal ectopic sebaceous gland (EESG) is a rare disease with a lower rate of detection because of no clinical symptoms and benign endoscopic presentation. Owing to the rarity of EESG, the clinical features and endoscopic characteristics were only described in case reports. The aims of this study are to determine

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Summary This 73‐year‐old female had undergone right middle lobe lobectomy for adenocarcinoma of lung (pT2N0M0) and got cured without recurrence. However, two years later, she was diagnosed as another cancer, uterine cervical squamous cell carcinoma (the International Federation of Gynecology and Obstetrics stage IIB), and received a series of concurrent chemoradiotherapy (CCRT). After 6 months of CCRT, she was admitted due to abdominal pain and nausea for one week. Physical examination disclosed mild epigasrtic tenderness and icteric sclera. Upper gastrointestinal endoscopy showed friable mucosa and narrowed lumen over the 2nd portion of duodenum, and the result of biopsy confirmed metastatic carcinoma of uterine cervix by positive for P16 immunohistochemically. Moreover, abdominal computed tomography (CT) scan disclosed increased infiltrative soft tissue at pancreatic head, uncinate process, pancreaticoduodenal groove, with eccentric thickening of the wall of bulb to 1st – 2nd portion of duodenum. The diagnosis was made as uterine cervical squamous cell carcinoma with duodenal metastasis and intestinal obstruction. The patient received supportive care. However, she died due to sepsis about one month later. Small intestinal neoplasm is rare and adenocarcinoma is more prevalent than other types of tumors. Common metastatic sites of uterine cervical cancer are the liver, lung, and bone marrow. Small intestine metastasis is found only in about 1.5 – 5.3% of patients with uterine cervical carcinoma beyond stage IIA. The presentation of patients with duodenal metastasis varies from epigastric pain, upper gastrointestinal hemorrhage to intestinal obstruction. Diagnosis is difficult and dependent on high alert of clinical physicians. Upper gastrointestinal endoscopy, CT scan or endoscopic retrograde cholangiopancreatography could be used to detect obstructive lesion, but the diagnosis is only made by biopsy with immunohistochemical stain. However, to diagnose it correctly and instantly is important because long term prognosis of patients with duodenal metastases is extremely poor without effective treatment. The pearl of this case is that clinical physician should keep alert for small intestinal neoplasm, even the flat type, in the patients who have history of other primary malignancy, such as cervical cancer. Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.

Summary Background The aim of this prospective study was to evaluate the impact of cytochrome P450 2C (CYP2C19) and interleukin‐1β (IL‐1β) polymorphisms on the efficacy of Helicobacter pylori (H. pylori) eradication by using rabeprazole‐based sequential therapy. Methods From March 2013 to May 2014, total 87 H. pylori‐infected patients were recruited to receive a 10‐day of sequential therapy. We had excluded 4 patients from analysis because of incomplete compliance. We performed either follow‐up endoscopy or 13C‐urea test to assess the treatment response. CYP2C19 and IL‐1β genotypes were analyzed to investigate the impact on H. pylori eradication. Results On the whole, the eradication rate of H. pylori was 80.72% (67/83). The rates of H. pylori eradiation were 79.31% in extensive metabolizers (EM) and 81.48% in non‐EM according to the CYP2C19 genotypes. The rates of H. pylori eradiation were 80.00% in the normal acid secretion group and 81.03% in the low acid secretion group according to the IL‐1β genotypes. After multivariable logistic regression analysis, both genotypes of CYP2C19 and IL‐1β were not significantly independent factors of H. pylori eradication. Conclusions Both CYP2C19 and IL‐1β polymorphisms would not have influences on eradication rates of H. pylori by using sequential therapy. Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.