Heterotopic gastric mucosa (inlet patch) in a patient with laryngopharyngeal reflux (LPR) and laryngeal carcinoma: a case report and review of literature
| Autor: | Jeffrey L. Conklin, R. B. Mertens, Omid Shaye, Simon K. Lo, G. S. Bellack, Benjamin Basseri |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Larynx medicine.medical_specialty Time Factors Fundoplication Endoscopic mucosal resection Choristoma Esophageal Diseases Risk Assessment Catheterization Laryngopharyngeal reflux medicine Humans Esophagus Laryngeal Neoplasms Neoplasm Staging business.industry Biopsy Needle technology industry and agriculture Gastroenterology Heartburn General Medicine medicine.disease Combined Modality Therapy Immunohistochemistry Dysphagia Surgery Treatment Outcome medicine.anatomical_structure Gastric Mucosa Esophageal stricture Carcinoma Squamous Cell Esophageal Stenosis Gastroesophageal Reflux cardiovascular system Adenocarcinoma Female Esophagoscopy medicine.symptom business Follow-Up Studies |
| Zdroj: | Diseases of the Esophagus. 22:E1-E5 |
| ISSN: | 1442-2050 1120-8694 |
| DOI: | 10.1111/j.1442-2050.2008.00915.x |
| Popis: | The inlet patch is an area of heterotopic gastric mucosa most commonly located in the postcricoid portion of the esophagus at, or just below, the level of the upper esophageal sphincter. Esophageal and supraesophageal symptoms are commonly associated with inlet patch, while esophageal adenocarcinoma rarely complicates it. Laryngeal adenocarcinoma associated with inlet patch is not described in the literature. Herein, we present the first reported case of inlet patch associated with laryngeal carcinoma. A 33-year-old female with long-standing asthma and presumed gastroesophageal reflux developed laryngeal cancer at age 22 years that was treated with concomitant radiation and induction chemotherapy. Subsequently, she had refractory heartburn, dysphagia, and cough. These symptoms continued despite two Nissen fundoplications, glottic web division, and optimal medical management. Upper endoscopy at our institution revealed an upper esophageal stricture and a 1 cm inlet patch. Biopsies showed columnar mucosa (predominantly gastric cardiac/fundic type) consistent with inlet patch, with focal intestinal metaplasia. Subsequent endoscopic mucosal resection of the inlet patch resulted in an amelioration of throat and chest pain, cough, and hoarseness. Dysphagia and regurgitation were improved by serial dilatations of the upper esophageal stricture. This case reveals a number of clinical findings associated with inlet patch--chest pain, dysphagia, cough, and hoarseness--as well as a clinical finding that has not been previously associated with inlet patch: laryngeal cancer. Symptoms refractory to optimal medical management and/or surgical intervention should make the clinician and endoscopist more cognizant of the inlet patch. |
| Databáze: | OpenAIRE |
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