Stefan Hartl, Joerg-Ruediger Siewert, FACS and Joerg Theisen

Department of Surgery, Klinikum rechts der Isar, Technische Universitaet München, Ismaningerstr.22, 81675 Munich, Germany.

Abstract

This report describes a complicated course of a 58-year-old patient with multicentric Barrett’s carcinoma within a long-segment of Barrett metaplasia. After abdominal-thoracic resection of the cancer, with incomplete removal of the long-segment metaplastic lesion, invasive carcinoma was diagnosed in the remnant Barrett’s segment. Endoscopic mucosal resection was done, but Barrett’s mucosa was left in situ again. Recurrent tumor growth was diagnosed only few months later. Finally, transthoracic complete resection on the remnant Barrett’s segment was performed. Thus, our case demonstrates impressively the appearance of multicentric adenocarcinomas in Barrett’s esophagus and underlines the necessity of resection of the complete Barrett mucosa.