Esophageal varices and early esophageal cancer: can we perform endoscopic mucosal resection (EMR)?

Management of high grade dysplasia in Barrett's oesophagus with underlying oesophageal varices: A retrospective study

“…Endomucosal resection can be effectively performed for the treatment of small, early oesophageal squamous cell carcinoma [24], usually for patients unwilling or unsuitable to undergo surgery. Endomucosal resection has been successful for early oesophageal neoplasia in cirrhotic patients with oesophageal varices, but only after complete oesophageal varices eradication [25][26][27][28]. Sawaguchi et al described ESD of nine oesophageal squamous cell carcinomas with oesophageal varices, preceded by EBL two cases when the neoplasia was on the oesophageal varices [29].…”

Endoscopic Submucosal Dissection Combined With Endoscopic Injection Sclerotherapy for Early Gastric Cancer on Gastric Fundal Varices

“…3 Controlling hemodynamics of GFVs is essential before further invasive treatment by endoscopic procedure, but currently there is no guideline for EGC on GFVs. Although effectiveness of EMR combined with EIS or EVL for early esophageal cancers on esophageal varices were demonstrated, 1,7 previous studies revealed that control of GFVs was more challenging than that of GCVs associated with esophageal varices, as GFVs were quite different from GCVs in angioarchitecture. 8,9 Previous studies represented that most of GFVs were developed to large caliber varices in submucosa as a part of splenogastrorenal shunt running through the gastric wall, 9 but GFVs in this case had no communication with other obvious vessels of portosystemic blood shunt.…”

“…[1][2][3][4][5] However, endoscopic treatment for patients with liver cirrhosis might possess bleeding tendency, 5 resulting in life-threatening bleeding 6 ; hence, the control of bleeding is important to achieve curative treatment. Although effectiveness of endoscopic mucosal resection (EMR) combined with endoscopic injection sclerotherapy (EIS) or endoscopic variceal ligation (EVL) for early esophageal cancers on esophageal varices were demonstrated, 1,7 currently there is little report of effective treatment for EGC on gastric fundal varices (GFVs).…”

“…Further studies are needed to establish not only the indication of endoscopic treatment in cirrhotic patients but also the pre-ESD strategy to eradicate GFVs based on hemodynamics, such as EIS, transjuglar intrahepatic portosystemic shunt, or balloon-occluded retrograde transvenous obliteration. 1,2,7 …”

Synchronous Esophageal Squamous Cell Carcinoma and Esophageal Variceal Bleeding due to Idiopathic Portal Hypertension: A Case Report

“…There are few case reports on the association of ESCC with esophageal variceal bleeding. But most of these cases are associated with endoscopic sclerotheraphy of varices [9, 10]. …”