Long-standing Uncontrolled Gastroesophageal reflux disease (GERD) Progressing to Barrett’s Esophagitis and Subsequently Esophageal Adenocarcinoma: A Case Report
Abstract
Gastroesophageal reflux disease (GERD) is a prevalent chronic gastrointestinal disorder that can lead to serious complications when inadequately treated. Persistent reflux-induced mucosal injury may progress through the metaplasia–dysplasia–carcinoma sequence, resulting in Barrett’s esophagus and, ultimately, esophageal adenocarcinoma. I report the case of a 65-year-old obese male smoker with a more than 15-year history of GERD and a previous diagnosis of Barrett’s esophagus with low-grade dysplasia made approximately 8 years earlier. Despite recommendations for long-term proton pump inhibitor therapy and routine endoscopic surveillance, the patient reported poor treatment adherence and irregular follow-up. Over the 12–18 months preceding presentation, he developed progressive dysphagia that advanced from solids to semi-solid foods accompanied by weight loss, reduced appetite, recurrent vomiting, fatigue, generalized weakness, and progressive malnutrition. Physical examination revealed cachexia, pallor, and muscle wasting. Upper gastrointestinal endoscopy identified long-segment Barrett’s esophagus involving the distal esophagus and an irregular partially obstructing mass. Histopathological analysis confirmed well-differentiated esophageal adenocarcinoma arising in Barrett’s esophagus with intestinal metaplasia. Contrast-enhanced computed tomography demonstrated circumferential thickening of the distal esophageal wall extending to the gastroesophageal junction with luminal…
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