Esophagus
Carcinoma
Adenocarcinoma arising in ectopic gastric mucosa


Topic Completed: 1 June 2013

Revised: 25 February 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Adenocarcinoma arising in ectopic gastric mucosa

See also: Adenocarcinoma, Gastroesophageal junction, Intramucosal carcinoma
Page views in 2018: 57
Page views in 2019 to date: 96
Cite this page: Weisenberg E. Adenocarcinoma arising in ectopic gastric mucosa. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagusadenocarcinomaectopic.html. Accessed May 26th, 2019.
Definition / general
  • Adenocarcinoma arising in ectopic gastric mucosa or perhaps mucosal / submucosal glands in the upper 1/3 of esophagus, most cases believed to arise in inlet patches
Epidemiology
  • Very rare, only single case reports
Sites
  • Generally upper 1/3 of esophagus
Pathophysiology
  • Embryologically, upper esophagus is last part of esophagus to acquire a squamous lining; if replacement of columnar epithelium is incomplete at birth, ciliated cells may persist, undergo gastric differentiation and become an inlet patch
  • Most inlet patches are clinically insignificant, although peptic ulcer disease is reported
  • Pathologic mechanism similar to Barrett associated carcinoma is also proposed (see below)
Etiology
  • Speculative, due to its rarity
  • Commonly ectopic gastric mucosa is colonized by H. pylori in individuals with gastric colonization
  • Conceivably the same factors that cause gastric adenocarcinoma may be operative in ectopic gastric mucosa
  • Alternatively, expression of CK7 and CK20 and mucin core proteins suggests that in at least some cases, a pathogenic link between Barrett esophagus and the cervical inlet patch may exist (Am J Surg Pathol 2005;29:437)
Clinical features
  • Behavior similar to Barrett associated adenocarcinoma
Diagnosis
  • Endoscopic biopsy
Case reports
Treatment
  • Similar to Barrett associated adenocarcinoma
Microscopic (histologic) description
  • Most are intestinal type adenocarcinoma
Microscopic (histologic) images

AFIP images

Well differentiated adenocarcinoma

Positive stains
Differential diagnosis
  • Carcinoma arising in Barrett epithelium where malignancy has overgrown metaplastic epithelium
  • Metastasis
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