Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Dumping Syndrome/drug therapy , Gastrointestinal Agents/therapeutic use , Octreotide/therapeutic use , Peptides, Cyclic/therapeutic use , Somatostatin/analogs & derivatives , Adult , Delayed-Action Preparations , Humans , Male , Somatostatin/therapeutic useSubject(s)
Colonic Neoplasms/prevention & control , Colonic Polyps/prevention & control , Colonoscopy/methods , Endoscopy, Digestive System/methods , Proctoscopes , Rectal Neoplasms/prevention & control , Adult , Aged , Aged, 80 and over , Colonic Neoplasms/surgery , Colonic Polyps/surgery , Female , Humans , Male , Middle Aged , Physicians, Family , Rectal Neoplasms/surgeryABSTRACT
Barrett's oesophagus is a premalignant condition. The possibility of eradicating at least partially the metaplastic epithelium has been reported recently. In this case report, a patient with Barrett's oesophagus complicated by high grade dysplasia and focal adenocarcinoma was treated by Nd:Yag laser then high dose rate intraluminal irradiation while on omeprazole 40 mg/day. A partial eradication of Barrett's oesophagus and a transient tumoural regression were obtained. Histologically, residual specialized-type glandular tissue was observed beneath regenerative squamous epithelium. Four months after intraluminal irradiation, a local tumoural recurrence was detected while the area of restored squamous epithelium was unchanged on omeprazole 40 mg/day. This indicates that physical destruction of Barrett's oesophagus associated with potent antisecretory treatment can induce a regression of the metaplastic epithelium, even in presence of high grade dysplasia. The persistence of specialized-type glands beneath the squamous epithelium raises important issues about its potential malignant degeneration.