ABSTRACT
Heterotopic gastric mucosa (HGM) can be found throughout the entire gastrointestinal tract, more frequently in the cervical oesophagus. Macroscopic HGM is named inlet patch (IP). The great majority of IPs are asymptomatic and discovered incidently during oesophageal endoscopy performed for another pathology. However, complications can occur. Among these, perforation is extremely rare. We report a case of a 27-year old man who presented with a perforation of an upper oesophageal ulcer arising from an IP. The diagnosis was made during endoscopy and confirmed with biopsy of the tissue surrounding the perforation, showing histologic modifications consistent with heterotopic gastric mucosa. Medical treatment using a proton pump inhibitor and antibiotics delivered with a gastric tube was advocated. The perforation was closed at day 7 and plasma Argon coagulation of the inlet patch was performed two months later. Annual endoscopy has been normal for three years.
Subject(s)
Choristoma/complications , Esophageal Diseases/complications , Esophageal Perforation/etiology , Gastric Mucosa , Ulcer/complications , Adult , Anti-Bacterial Agents/therapeutic use , Anti-Ulcer Agents/therapeutic use , Biopsy , Esophagoscopy , Follow-Up Studies , Humans , Male , Proton Pump Inhibitors/therapeutic useABSTRACT
INTRODUCTION: The course and prognosis of basaloid squamous cell carcinoma (BSCC) are not well known. OBJECTIVES: To study the course and prognosis in a population of BSCC patients. MATERIALS AND METHODS: We analyzed a retrospective cohort of 49 patients with BSCC in comparison with a cross-matched population of 49 patients treated for well- to moderately differentiated squamous cell carcinoma (SCC). RESULTS: The statistical analysis showed that survival in BSCC group was lower than in the SCC group. Local recurrence in the BSCC group was not higher than in the SCC group, but mortality by distant metastasis was six times higher than in the SCC population. CONCLUSIONS: We consider BSCC patients as a high-risk population and we complete diagnosis explorations including a FDG-PET before curative treatment. We also recommend post-operative or exclusive radiotherapy which may be associated with concomitant chemotherapy.
