Esophageal squamous cell papilloma on the background of gastroesophageal reflux disease: a clinical case in a 23-year-old obese man.

Authors

DOI:

https://doi.org/10.26641/1997-9665.2019.3.162-169

Keywords:

gastroesophageal reflux disease, obesity, squamous papilloma, low-grade dysplasia

Abstract

Background. A number of weighting factors, primarily obesity and manifestations of duodenogastroesophageal reflux (DGER), are correlated with the presence of inflammation and an increased risk of progression of negative changes in the esophagus with gastroesophageal reflux disease (GERD). This should be considered when screening for GERD using esophagogastroduodenoscopy (EGDS). Objective: to draw the attention of doctors to the need for early screening of morphological changes in the mucous membrane of the esophagus among young people with obesity, as an example of a clinical case. Methods. 23-year-old man with overweight, heartburn, bloating. Heartburn has been troubling for more than two years. Smokes. Has a family history of cancer of the upper gastrointestinal tract. On endoscopy: 38 cm from the upper incisors, a single, 3 mm in diameter, polypoid whitish formation was found, it rises on a broad basis. In the stomach – a significant amount of bile. Pylorus – open. Biopsy samples of the gastric mucosa (antrum, body) were taken. A quick urease test is negative. The removal of the formation of the esophagus. In a histological examination of the formation of the esophagus, we revealed squamous papilloma with low-grade epithelial dysplasia, chronic esophagitis, and reflux gastritis. Final diagnosis: GERD with chronic esophagitis. Squamous cell papilloma of the esophagus with mild epithelial dysplasia. Reflux gastritis, inactive. Obesity of 1 degree. Results. According to the literature, obesity, smoking, a family history of cancer are risk factors for GERD and the most common events among patients with squamous esophageal papilloma. DHER promotes the formation of GERD, esophagitis, metaplasia and neoplasia of the surface epithelium of the mucous membrane of the esophagus. But there is no scientific evidence for the benefits of endoscopic screening for GERD among obese young adults. Conclusion. A clinical case demonstrates that screening endoscopy in a young man against the background of factors aggravating the course of GERD revealed lesions of the esophagus in the form of squamous papilloma with epithelial dysplasia. Further studies are needed to confirm the benefits of endoscopic screening for GERD in obese young adults.

References

  1. Valezi AC, Herbella FAM, Schlottmann F, Patti MG. Gastroesophageal Reflux Diseasein Obese Patients. J LaparoendoscAdvSurgTech A. 2018;28(8):949-952. doi: 10.1089/lap.2018.0395.
  2. Lynch KL. Is Obesity Associated with Barrett's Esophagus and Esophageal Adenocarcinoma? Gastroenterol ClinNorthAm. 2016;45(4):615-624. doi: 10.1016/j.gtc.2016.07.002.
  3. Lee YY, McColl KE. Disruption of the gastroesophageal junction by central obesity and waist belt: role of raisedintra-abdominal pressure. Dis Esophagus. 2015;28(4):318-25. doi: 10.1111/dote.12202.
  4. Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ. American Gastroenterological Association technical review on the management of Barrett's esophagus. American Gastroenterological Association. Gastroenterology. 2011;140(3):e18-52; quiz e13.
  5. Du X, Hidayat K, Shi BM. Abdominal obesity and gastroesophageal cancer risk: systematicreviewandmeta-analysisofprospectivestudies. BiosciRep. 2017;37(3). pii: BSR20160474. doi: 10.1042/BSR20160474. Print 2017 Jun 30.
  6. Bytzer P, Jones R, Vakil N. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Limited ability of the proton-pump inhibitor test to identify patients with gastroesophageal reflux disease. ClinGastroenterolHepatol 2012;10:1360–6.doi:10.1016/j.cgh.2012.06.030.
  7. Gyawali CP, Kahrilas PJ, Savarino E. Moderndiagnosisof GERD: the Lyon Consensus. Gut. 2018;67(7):1351-1362. doi: 10.1136/gutjnl-2017-314722.
  8. Sifrim D, Zerbib F. Diagnosis and management of patients with reflux symptoms refractory to protonpump inhibitors. Gut. 2012;61:1340–54.doi:10.1136/gutjnl-2011-301897
  9. Gyawali CP, Fass R. ManagementofGastroesophagealRefluxDisease. Gastroenterology. 2018;154:302–18.doi:10.1053/j.gastro.2017.07.049
  10. Song X, Li W, Hu N, Zhao XK. GWAS follow-up study of esophageal squamous cell carcinoma identifies potential genetic loci associated with family history of uppergastrointestinal cancer. SciRep. 2017;7:4642. doi: 10.1038/s41598-017-04822-2.
  11. Shaheen NJ, Falk GW, Iyer PG. Diagnosisand Management of Barrett`s Esophagus. Am. J. Gastroenterol. 2015;3:1-21. doi: 10.1038/ajg.2015.322.
  12. Nam SY, Choi IJ, Ryu KH. Abdominal visceral adipose tissue volume is associated with increased risk of erosive esophagitis in men and women. Gastroenterology. 2010;139:1902–1911.e2.
  13. Hazelton WD, Curtius K, Inadomi JM, Vaughan TL, Meza R, Rubenstein JH, Hur C, Luebeck EG. The Role of Gastroesophageal Reflux and Other Factors during Progression to Esophageal Adenocarcinoma Cancer Epidemiol BiomarkersPrev; 2015;24(7):1012–23. DOI: 10.1158/1055-9965.EPI-15-0323-T.
  14. Aune D, Greenwood DC, Chan DS. Bodymassindex, abdominal fatness and pancreatic cancer risk: a systematic review and non-lineardose–responsemeta-analysisofprospectivestudies. AnnOncol. 2012;23:843–852.
  15. Kern L, Mittenbühler MJ, Vesting AJ. Obesity-Induced TNFα and IL-6 Signaling: The Missing Link between Obesity and Inflammation-DrivenLiverandColorectalCancers. Cancers (Basel). 2018;11(1).pii:E24. doi: 10.3390/cancers11010024.
  16. Singh S1, Sharma AN, Murad MH, Buttar NS, El-Serag HB, Katzka DA, Iyer PG. Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, andadenocarcinoma: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11(11):1399-1412.e7. doi: 10.1016/j.cgh.2013.05.009. Epub 2013 May 22.
  17. Steffen A1, Huerta JM, Weiderpass E. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation. CancerandNutrition. 2015;137(3):646-57. doi: 10.1002/ijc.29432. Epub 2015 Feb.
  18. Nelsen EM, Kirihara Y, Takahashi N. Distribution of Body Fat and Its Influence on Esophageal Inflammation and Dysplasiain Patients With Barrett’s Esophagus. Clinical gastroenterology and hepatology. 2012;10:728–734.
  19. Jideh B, Weltman M, Wu Y, Chan CHY. Esophageal squamous papilloma lacks clear clinicopathological associations. World J ClinCases. 2017;5(4):134–139. doi: 10.12998/wjcc.v5.i4.134 PMCID: PMC5395981 PMID: 28470005.
  20. Cho JY, Cheung DY, Kim TJ, Kim JK. A Case of Esophageal Squamous Cell Carcinoma in situ Arising from Esophageal Squamous Papilloma. ClinEndosc. 2019;52(1):72-75. doi: 10.5946/ce.2018.058.
  21. Syrjänen K, Syrjänen S. Detection of human papilloma virus in esophageal papillomas: systematic review and meta-analysis. APMIS. 2013;121(5):363-74. doi: 10.1111/apm.12003.
  22. Duits LC, Phoa KN, Curvers WL. Barrett’s oesophagus patients with low-grade dysplasia can be accurately risk-stratified after histological review by an exper tpathologypanel. Gut. 2015;64(5):700–706
  23. McQuaid KR, Laine L, Fennerty MB, Souza R, Spechler SJ. Systematic review: the role of bileacids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia. AlimentPharmacolTher. 2011;34(2):146-65. doi: 10.1111/j.1365-2036.2011.04709.x.

Downloads

How to Cite

Scherbinina, M. B., Hladun, V. M., & Korolenko, A. S. (2019). Esophageal squamous cell papilloma on the background of gastroesophageal reflux disease: a clinical case in a 23-year-old obese man. Морфологія / Morphologia / Morfologìâ, 13(3), 162–169. https://doi.org/10.26641/1997-9665.2019.3.162-169

Issue

Vol. 13 No. 3 (2019)

Section

Статті

License

Copyright (c) 2019 Morphologia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.