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

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
,
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
,
1   Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India
› Institutsangaben
Funding None.

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.

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.




Publikationsverlauf

Artikel online veröffentlicht:
23. Dezember 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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  • References

  • 1 Philpott H, Garg M, Tomic D, Balasubramanian S, Sweis R. Dysphagia: Thinking outside the box. World J Gastroenterol 2017; 23 (38) 6942-6951
  • 2 Rommel N, Hamdy S. Oropharyngeal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol 2016; 13 (01) 49-59
  • 3 Goel A, Lakshmi CP, Bakshi SS, Soni N, Koshy S. Single-center prospective study of Plummer-Vinson syndrome. Dis Esophagus 2016; 29 (07) 837-841
  • 4 Patil M, Malipatel R, Devarbhavi H. Plummer-Vinson syndrome: A decade's experience of 132 cases from a single center. J Gastroenterol Hepatol 2021; 36 (01) 181-185
  • 5 Harmouch F, Liaquat H, Chaput KJ, Geme B. Plummer-Vinson Syndrome: A Rare Cause of Dysphagia in an Octogenarian. Am J Case Rep 2021; 22: e929899
  • 6 Mansell NJ, Jani P, Bailey CM. Plummer-Vinson syndrome–a rare presentation in a child. J Laryngol Otol 1999; 113 (05) 475-476
  • 7 Sreenivas DV, Kumar A, Mannar KV, Babu GR. Results of Savary-Gilliard dilatation in the management of cervical web of esophagus. Hepatogastroenterology 2002; 49 (43) 188-190
  • 8 Goel A, Bakshi SS, Soni N, Chhavi N. Iron deficiency anemia and Plummer-Vinson syndrome: current insights. J Blood Med 2017; 8 (08) 175-184
  • 9 Larsson LG, Sandström A, Westling P. Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden. Cancer Res 1975; 35 (11 Pt. 2): 3308-3316
  • 10 Mohan P, Munisamy M, Selvan KS, Hamide A. Esophageal squamous cell cancer in Plummer-Vinson syndrome: Is lichen planus a missing link?. J Postgrad Med 2022; 68 (02) 98-99
  • 11 Sewnaik A, Hoorweg JJ, Knegt PP, Wieringa MH, van der Beek JM, Kerrebijn JD. Treatment of hypopharyngeal carcinoma: analysis of nationwide study in the Netherlands over a 10-year period. Clin Otolaryngol 2005; 30 (01) 52-57
  • 12 Probst A, Aust D, Märkl B, Anthuber M, Messmann H. Early esophageal cancer in Europe: endoscopic treatment by endoscopic submucosal dissection. Endoscopy 2015; 47 (02) 113-121
  • 13 Geerlings SE, Statius van Eps LW. Pathogenesis and consequences of Plummer-Vinson syndrome. Clin Investig 1992; 70 (08) 629-630
  • 14 Nasa M, Patil G, Sharma Z, Puri R. Plummer-Vinson Syndrome with Simultaneous Mid-esophageal Growth. J Assoc Physicians India 2017; 65 (02) 96-97
  • 15 Eckardt VF, Kanzler G, Willems D. Single dilation of symptomatic Schatzki rings. A prospective evaluation of its effectiveness. Dig Dis Sci 1992; 37 (04) 577-582
  • 16 Sung H, Ferlay J, Siegel RL. et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71 (03) 209-249
  • 17 Wang KK, Prasad G, Tian J. Endoscopic mucosal resection and endoscopic submucosal dissection in esophageal and gastric cancers. Curr Opin Gastroenterol 2010; 26 (05) 453-458
  • 18 Aabakken L. Endoscopic diagnosis and treatment of tumors. Endoscopy 2009; 41 (10) 861-865
  • 19 Ning B, Abdelfatah MM, Othman MO. Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer. Ann Cardiothorac Surg 2017; 6 (02) 88-98
  • 20 Aadam AA, Abe S. Endoscopic submucosal dissection for superficial esophageal cancer. Dis Esophagus 2018; 31(07):
  • 21 Joo DC, Kim GH, Park DY, Jhi JH, Song GA. Long-term outcome after endoscopic submucosal dissection in patients with superficial esophageal squamous cell carcinoma: a single-center study. Gut Liver 2014; 8 (06) 612-618
  • 22 Qi L, He W, Yang J, Gao Y, Chen J. Endoscopic balloon dilation and submucosal injection of triamcinolone acetonide in the treatment of esophageal stricture: A single-center retrospective study. Exp Ther Med 2018; 16 (06) 5248-5252
  • 23 An W, Liu MY, Zhang J. et al. Endoscopic submucosal dissection versus esophagectomy for early esophageal squamous cell carcinoma with tumor invasion to different depths. Am J Cancer Res 2020; 10 (09) 2977-2992
  • 24 Bakari G, Benelbarhdadi I, Bahije L, El Feydi Essaid A. Endoscopic treatment of 135 cases of Plummer-Vinson web: a pilot experience. Gastrointest Endosc 2014; 80 (04) 738-741
  • 25 Rushfeldt C, Aabakken L. Implementation of Endoscopic Submucosal Dissection for Gastric Lesions in Norway. Scand J Surg 2016; 105 (02) 90-96