Diagnosis and management of a rare case of esophageal epidermoid metaplasia: A case report
Abstract
BACKGROUND Esophageal epidermoid metaplasia (EEM) is a rare potentially premalignant oesophageal lesion characterized by a dense granular layer with overlying hyperorthokeratosis resembling the epidermis of skin. Given the low prevalence, data to guide management also remains sparse. CASE SUMMARY We highlight a case of a 60-year-old male who presented with gastroesophageal reflux disease symptoms 2 years after an index gastroscopy which showed C0M1 Barrett’s oesophagus. The repeat gastroscopy detected a 15 mm oesophageal epidermoid metaplasia on a background of stable Barrett’s esophagus. This was rather peculiar as the images form his index gastroscopy 2 years prior did not reveal any suspicious oesophageal mucosal abnormality. He underwent a successful endoscopic mucosal resection within 3 months with a surveillance gastroscopy scheduled 6 months later. The cases of confirmed EEM are very low. One study demonstrated out of 1048 consecutive oesophageal biopsies and resections for any indication, only two were EEM (0.19%). It was also noted that the prevalence of epidermoid metaplasia was significantly higher (P < 0.05) in the 58 patients with oesophageal squamous neoplasms, two of whom (3.5%) had concurrent epidermoid metaplasia. CONCLUSION This association necessitates careful consideration when determining resection vs surveillance-based management of EEM.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 58 participants or records.
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