case_images: PMC11779616_01
case_images: (A) White light endoscopy suggesting a dumbbell-shaped submucosal elevation in the lower esophagus; (B) preoperative EUS image showing a hypoechoic nodule in the submucosal layer with clear borders; (C) complete endoscopic resection of the lesion; (D) postoperative specimen.
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case_images: PMC11779616_01_fonc-14-1482068-g001.jpg
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case_images: The patient underwent gastroscopy on March 19, 2024, due to a retrosternal tingling sensation after eating, which revealed a submucosal dumbbell-shaped bulge in the esophagus 33 cm from the incisors, approximately 0.6-0.8 cm in size ( Figure 1A ). Treatment: Preoperative ultrasonographic endoscopy suggested a hypoechoic esophageal region 33 cm from the incisors, with a lesion originating in the submucosal layer ( Figure 1B ), measuring approximately 0.6 cm in size and of undetermined nature. The patient underwent endoscopic mucosal dissection under endotracheal intubation anesthesia ( Figure 1C ) with complete resection of the tumor ( Figure 1D ).
case_images: (A) Slight localized wall thickening of the lower esophagus is seen in the cross-sectional view of thoracic and abdominal enhanced CT in the venous phase; (B) No significant enhancement of the lower esophagus is seen in the cross-sectional view of thoracic and abdominal enhanced CT in the arterial phase; (C, D) no abnormality of the wall of the esophagus is seen in the oblique sagittal position of thoracic and abdominal enhanced CT in the venous phase and in the arterial phase.
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case_images: PMC11779616_01_fonc-14-1482068-g002.jpg
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case_images: Additionally, small nodular lesions were identified in the lower lobes of both lungs, and small gallstones were present in the gallbladder. ( Figure 2 ).
case_images: (A) High-magnification view of the tumor consisting of multiple dilated ducts or cysts arranged in a gland duct-like pattern, with medial gland epithelial cells and lateral basal cells visible in the dilated ducts; (B) Immunohistochemistry showing CK5/6 (basal cells +); (C) Immunohistochemistry MUC2 (-), MUC5AC (-), MUCS6 (-); (D) Immunohistochemistry P63 (basal cells +).
case_images: fonc-14-1482068-g003.jpg
case_images: PMC11779616_01_fonc-14-1482068-g003.jpg
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case_images: Postoperative pathological findings confirmed the diagnosis of esophageal submucosal gland duct adenoma ( Figure 3A ). Immunohistochemical analysis showed CK5/6 (basal cell +) ( Figure 3B ), MUC2 (-), MUC5AC (-), MUCS6 (-) ( Figure 3C ), and P63 (basal cell +) ( Figure 3D ).