Esophageal Epidermoid Metaplasia - A Management Dilemma

Alhaqqan, Dalal; Sussman, Daniel A.; Girotra, Mohit

doi:10.14309/00000434-201810001-01829

Cited by 3 publications

(3 citation statements)

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“…No guidelines exist for the ideal frequency and pattern for evaluation or surveillance of esophageal leukoplakia [ 10 ]. Given concern for preneoplastic potential and its association with squamous cell dysplasia and esophageal cancer, the need for close surveillance or endoscopic interventions has been suggested [ 1 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Esophageal Leukoplakia in Achalasia

Kanagalingam¹,

Achuo-Egbe²,

Ahmed³

et al. 2022

Cureus

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Esophageal leukoplakia refers to a clinical finding of a white patch on the mucous membrane surface that cannot be scraped off. It has been associated with alcohol and tobacco use and chronic acid reflux. An association with squamous cell dysplasia and carcinoma has been reported with potential for malignant transformation warranting endoscopic intervention or surveillance, but no guidelines exist. We present a case of a 77-year-old female with a history of longstanding achalasia requiring multiple Botox injections. After presenting with weight loss, esophageal dysphagia, and acid reflux the patient underwent an esophagogastroduodenoscopy (EGD) showing a 20 mm white plaque in the middle third of the esophagus and histopathology consistent with esophageal leukoplakia. After repeated Botox injection and treatment with PPI and H2 blocker, no findings of esophageal leukoplakia were noted on repeat EGD. With this case, we aim to increase awareness of this rare disease pathology, especially in the setting of underlying achalasia. This case also raises the question if maximum anti-reflux therapy could have a potential benefit in avoiding the recurrence of esophageal leukoplakia.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Esophageal Leukoplakia in Achalasia

Kanagalingam¹,

Achuo-Egbe²,

Ahmed³

et al. 2022

Cureus

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“…In our case multiple ablations were required due to residual lesion found on repeat endoscopy. Some clinicians propose annual endoscopic evaluation with four-quadrant biopsies at every 1cm of the affected area [ 12 ]. More studies are needed to establish universal surveillance guidelines.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Esophageal Leukoplakia: A Potential Precursor to Esophageal Malignancy

Ashraf¹,

Richter²,

Arker³

et al. 2021

Cureus

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Esophageal leukoplakia or epidermoid metaplasia is a rare lesion resembling the commonly found oral leukoplakia. When found, it is typically seen incidentally on endoscopy as a white plaque but rarely it may present as a globus sensation. Histologically, it is seen as epidermal metaplasia with orthokeratosis, closely resembling the skin. Although rare, esophageal leukoplakia is precancerous and may pose a serious threat. We present a unique case of a 61-year-old male with a history of COPD, tobacco, and alcohol dependence presenting with a six-month history of nausea and emesis resulting in poor oral intake despite having an appetite. The patient also reported weight loss. Considering his risk factors for esophageal carcinoma and alarm symptoms, an upper endoscopy was performed that revealed localized white, plaque-like mucosal changes characterized by altered texture in the lower third of the esophagus at 40cm. Biopsy results showed squamous epithelium with orthokeratosis and a prominent granular cell layer. These findings were consistent with esophageal epidermoid metaplasia. The lesion was ablated using argon plasma coagulation and radiofrequency ablation on subsequent endoscopy. The patient reported continued resolution of symptoms with each treatment session. Esophageal leukoplakia may increase the risk for squamous cell carcinoma of the esophagus and should be followed closely. Guidelines on surveillance are yet to be established given the rarity of the disease.

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“…Diese Veränderung ist sehr selten und ist durch ein Plattenepithel mit prominenter Granularzellschicht und Hyperkeratose charakterisiert. Sie tritt bei mittlerem bis höherem Alter vorwiegend im mittleren Ösophagus auf 2 3 . Wie bei der oralen Leukoplakie besteht auch hier ein Zusammenhang zur Plattenepitheldysplasie bzw.…”

Section: Diskussionunclassified

Hyperkeratose im Ösophagus – Ein ungeklärter Fall einer schweren Dysphagie

2023

Z Gastroenterol

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Esophageal Epidermoid Metaplasia - A Management Dilemma

Cited by 3 publications

References 0 publications

A Rare Case of Esophageal Leukoplakia in Achalasia

A Rare Case of Esophageal Leukoplakia in Achalasia

A Rare Case of Esophageal Leukoplakia: A Potential Precursor to Esophageal Malignancy

Hyperkeratose im Ösophagus – Ein ungeklärter Fall einer schweren Dysphagie

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