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CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(01): 051-055
DOI: 10.1055/s-0042-1759510
Case Report

Endoscopic Submucosal Dissection for Esophageal Squamous Cell High-grade Dysplasia in a Patient with Plummer Vinson Syndrome

Gaurav Patil 
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Amol Vadgaonkar
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Ankit Dalal 
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Sanil Parekh
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Animesh Shah
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Poorva Haridas
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Prajakta Gupte
2   Department of Pathology, HBT Medical College and Dr. R N Cooper Hospital, Mumbai, Maharashtra, India
,
Sehajad Vora
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
,
Amit Maydeo 
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
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Abstract

A 35-year female with Plummer Vinson syndrome (PVS) presented with a history of progressive dysphagia over six months, not responding to iron therapy and endoscopic dilatations. Her upper gastrointestinal endoscopy showed a post-cricoid web dilated using a Savary-Gilliard dilator. On NBI, a long segment circumferential lesion with abnormal microvascular architecture was noted in the mid esophagus. Biopsy showed high-grade dysplastic squamous epithelium. The patient underwent minimally invasive, circumferential endoscopic submucosal dissection (ESD) and received oral prednisolone to prevent stricture formation. Resected margins were free of dysplasia. At follow-up there was no evidence of recurrence or stricture formation. To our knowledge, this is the first case of PVS with squamous proliferation with high-grade dysplasia that was successfully treated with circumferential ESD. Screening endoscopy helps in the downstaging of early cancer, and timely intervention helps to treat this with a minimally invasive approach like ESD.

Keywords

endoscopic submucosal dissection - esophageal cancer - outcomes - plummer-vinson syndrome

Presentation at a Meeting

Not presented.


Author Contributions

Concept – GP; Design –GP, AV; Performed case – GP, SV; Data Collection and/or Processing –GP, AV; Literature Review- AD, PH, AS, SP; Performed histopathological analysis – PG; Writing – AS, AV, GP; Critical Reviews - AM.


All the authors reviewed and approved the final version of the manuscript.


Consent

Consent from the patient was obtained regarding the publication of this case.




Publication History

Article published online:
23 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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