Adenocarcinoma arising in a colonic interposition after esophagectomy for benign stricture and review of the literature

Abstract

Colon interposition in oesophageal replacement after oesophagectomy for benign strictures is associated with significant perioperative complications that carry high morbidity and mortality. Long-term sequelae such as further strictures and colonic redundancy are frequent. Adenocarcinoma in the colonic graft is rare. A 70-year-old female presented to our clinic with symptoms of dysphagia. When she was 51 years, she underwent left colonic oesophageal interposition for an oesophageal stricture caused by caustic ingestion. Studies revealed colonic adenocarcinoma in interposed colonic graft, with latero-cervical lymph nodes. She was proposed to neoadjuvant chemotherapy. Although long-term risk analysis is lacking, it’s not unreasonable to propose endoscopic screening according to general colonic cancer guidelines in patients with colonic interposition in oesophageal replacement after oesophagectomy.

Once a Colon, Always a Colon

“…Esophageal replacement by colonic interposition is a rare surgical procedure typically only used in advanced esophageal cancers, end-stage stricturing disease, or severe caustic ingestions. 1 Because of the scarcity of cases, there is little known regarding the long-term outcomes of the procedure. 1 There are a growing number of reports demonstrating the presence of colon polyps within the interposed colon.…”

“…1 Because of the scarcity of cases, there is little known regarding the long-term outcomes of the procedure. 1 There are a growing number of reports demonstrating the presence of colon polyps within the interposed colon. 2,3 These polyps range from simple adenomas to high-grade adenocarcinomas.…”

Successful Simultaneous Treatment of Benign Stricture and Colonic Neoplasm Arising from Colonic Interposition after Esophagectomy: A Case Report

“…1 To date, this has less than 10 case reports. 2 Moreover, only one case report on endoscopic submucosal dissection (ESD) treatment in interpositioned colon has been published; all others were on surgical treatment. The incidence of stenosis, as a late complication of colonic interposition, is approximately 12.8%.…”