Heterotopía de mucosa gástrica del esófago proximal como causa de distrés respiratorio en un neonato: reporte de caso / Gastric mucosa heterotopia of the proximal esophagus as a cause of respiratory distress in a newborn: case report

Introducción: la heterotopia de mucosa gástrica del esófago proximal (HMGEP) es una entidad clínica poco entendida y probablemente subdiagnosticada, que consiste en la presencia de islas de mucosa gástrica ectópica en el esófago proximal. Caso clínico: presentamos el caso de un neonato que presenta de manera temprana estridor y distrés respiratorio secundario a mucosa redundante en la región poscricoidea, que prolapsa sobre la supraglotis y ocluye la luz de la vía aérea. El estudio histopatológico reporta HMGEP. Se realiza una terapia ablativa con láser, con lo cual la paciente se recupera paulatinamente. Metodología: se llevó a cabo una amplia búsqueda de la literatura de HMGEP en las bases de datos PubMed, SciELO, Mendeley y Elsevier, en idioma inglés y español, desde 1980 a 2021 y se incluyeron 18 artículos en total. Discusión: la HMGEP suele ser una entidad asintomática que en ocasiones genera síntomas faringolaríngeos, y de manera infrecuente puede asociarse con complicaciones como estenosis, úlceras, perforación esofágica e incluso obstrucción de la vía aérea como en el presente caso. Conclusiones: además de las diversas alteraciones en la vía aérea que pueden generar estridor y dificultad respiratoria en niños, debemos descartar causas gastroesofágicas subyacentes asociadas con estas manifestaciones, como la HMGEP.logos y expertos en radioterapia permite obtener buenos resultados quirúrgicos y clínicos en la inmensa mayoría de casos.

Introduction: Gastric mucosal heterotopia of the proximal esophagus (HMGEP) is a poorly understood and probably underdiagnosed clinical entity that consists of the presence of islands of ectopic gastric mucosa in the proximal esophagus. Clinical Case: In this article, we present the case of a newborn who started with early stridor and respiratory distress secondary to redundant mucosa in the postcricoid region that prolapsed over the supraglottis, occluding the airway lumen. The histopathological study reports HMGEP. Ablative laser therapy is performed with which the patient gradually recovers. Methodology: An extensive search of the HMGEP literature was conducted in PubMed, SciELO, Mendeley, and Elsevier data base; in English and Spanish, from 1980 to 2021, including a total of 18 articles. Discussion: HMGEP is usually an asymptomatic entity that sometimes causes pharyngolaryngeal symptoms and, infrequently, can be associated with complications such as stenosis, ulcers, esophageal perforation, and even airway obstruction, as in the present case. Conclusions: In addition to the various alterations in the airway that can generate stridor and respiratory distress in children, we must rule out underlying gastroesophageal causes associated with these manifestations, such as HMGEP.

Heterotopic Salivary Gland Tissue at the Hepatic Flexure of the Large Intestine: A Case Report / 대한소화기학회지

The occurrence of heterotopic tissue in the large intestine is unusual. The most common heterotopic tissue type described is gastric-type mucosa. On the other hand, heterotopic salivary gland tissue in the large intestine is extremely rare. To the best of the authors' knowledge, only five cases of heterotopic salivary gland in the large intestine have been reported, and all cases arose in the left colon. One out of five cases arose in the sigmoid colon, and the four other cases were found in the rectum-anal canal region. Endoscopically, they usually appeared as a polyp. The presentation of the patients was rectal bleeding or asymptomatic. Heterotopic salivary gland tissue in the colon has not been reported in Korea. This paper reports a case of heterotopic salivary gland tissue at the hepatic flexure of the colon and reviews the literature on similar cases. A 55-year-old male underwent large bowel endoscopy for colorectal carcinoma screening. The colonoscopy revealed five polyps. A sessile polyp at the hepatic flexure, 0.6 cm in size, was resected in a piecemeal manner. The histopathologic findings revealed a salivary gland with mixed mucinous-serous features and ducts. The other four polyps all were diagnosed as tubular adenoma with low-grade dysplasia.

Adenocarcinoma Arising from Heterotopic Gastric Mucosa in Cervical Esophagus: A Case Report

Heterotopic gastric mucosa (HGM) of the upper esophagus, referred as "cervical inlet patch (CIP)", is a benign lesion that is present in 3.8-10% of the adult population. Adenocarcinomas arising from HGM of the upper esophagus are exceedingly rare. The authors report one additional case of histologically confirmed adenocarcinoma arising from a CIP. The patient had concomitant primary adenocarcinoma of the colon. The right hemicolectomy specimen and total esophagectomy specimen after preoperative chemoradiotherapy showed histologically different adenocarcinomas. The residual esophageal tumor was characterized by large mucin pools, fibrous septa, and floating tumor cells. HGM of both the fundic and antral types was seen on the surface and sides of the tumor. The independent origins of the two cancers were confirmed by immunohistochemical studies for cytokeratins 7 and 20. Without further treatment, the patient remained free of disease after 29 months of follow-up.