Four cancer cases after esophageal atresia repair: Time to start screening the upper gastrointestinal tract

World J Gastroenterol. 2018 Mar 7;24(9):1056-1062. doi: 10.3748/wjg.v24.i9.1056.

Abstract

Esophageal atresia (EA) is one of the most common congenital digestive malformations and requires surgical correction early in life. Dedicated centers have reported survival rates up to 95%. The most frequent comorbidities after EA repair are dysphagia (72%) and gastroesophageal reflux (GER) (67%). Chronic GER after EA repair might lead to mucosal damage, esophageal stricturing, Barrett's esophagus and eventually esophageal adenocarcinoma. Several long-term follow-up studies found an increased risk of Barrett's esophagus and esophageal carcinoma in EA patients, both at a relatively young age. Given these findings, the recent ESPGHAN-NASPGHAN guideline recommends routine endoscopy in adults born with EA. We report a series of four EA patients who developed a carcinoma of the gastrointestinal tract: three esophageal carcinoma and one colorectal carcinoma in a colonic interposition. These cases emphasize the importance of lifelong screening of the upper gastrointestinal tract in EA patients.

Keywords: Adenocarcinoma; Barrett’s esophagus; Esophageal atresia; Esophageal cancer; Screening; Squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / etiology*
  • Adenocarcinoma / therapy
  • Adult
  • Barrett Esophagus / diagnosis
  • Barrett Esophagus / etiology*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / etiology*
  • Carcinoma, Squamous Cell / therapy
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / etiology*
  • Colorectal Neoplasms / therapy
  • Digestive System Surgical Procedures / adverse effects*
  • Esophageal Atresia / diagnosis
  • Esophageal Atresia / surgery*
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / etiology*
  • Esophageal Neoplasms / therapy
  • Esophageal Squamous Cell Carcinoma
  • Fatal Outcome
  • Female
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / etiology*
  • Humans
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome

Supplementary concepts

  • Adenocarcinoma Of Esophagus