Band Ligation Resolves Esophageal Adenocarcinoma Overlying Esophageal Varix.

When early-stage esophageal cancer overlies an esophageal varix, endoscopic mucosal resection is not safe because of risk of variceal bleeding. We report a 59-year-old man with alcohol-related liver cirrhosis and an 8 mm Stage I adenocarcinoma in the distal esophagus overlying a large varix. After a multidisciplinary review, we performed band ligation of the nodular adenocarcinoma and varix. On follow-up upper endoscopy 2 months after banding, no evidence of residual adenocarcinoma was visualized. Pathologic biopsies returned negative for malignancy. Band ligation of early-stage esophageal adenocarcinoma may prove an effective option for patients who have nodular malignancies overlying an esophageal varix.