[A case of early esophageal adenocarcinoma arising from esophageal cardiac glands].

A 54-year-old man was referred to our hospital with an esophageal lesion. On esophagogastroduodenoscopy a pedunculated elevated lesion about 15mm in diameter was identified in the abdominal esophagus. The surface of the lesion had irregular nodules with white coating. We found no Barrett's mucosa around the lesion. A biopsy specimen of this tumor showed well-differentiated adenocarcinoma. A lower esophagus-proximal gastrectomy was performed because this tumor was suspected to invade the submucosal layer. Eventually, the histological diagnosis after resection was esophageal adenocarcinoma arising from cardiac glands, limited to the mucosal layer (M2). This origin of the esophageal adenocarcinoma is rare. Furthermore, this form of the tumor is especially unusual, and there have been few reports of similar cases.

Adenocarcinoma of Meckel's diverticulum diagnosed by capsule endoscopy and single-balloon enteroscopy.

A case of adenocarcinoma arising in Meckel's diverticulum in a 58-year-old man is reported. Abdominal computed tomography and ultrasonography showed a solid tumor in the middle of abdomen. Capsule endoscopy (CE) showed tumorous lesion in the distal ileum. Single-balloon enteroscopy (SBE) subsequently showed the tumor in Meckel's diverticulum. Furthermore, biopsy specimen obtained from the lesion revealed it as adenocarcinoma. At laparotomy, we found the tumor at the blind end of the diverticulum and enlarged lymph node about 7 cm in diameter in the small intestinal mesentery. Segmental resection of the ileum, including the tumor-bearing diverticulum, was performed along with regional lymph node dissection. Histologically, origin of the tumor was assumed to be ectopic gastric mucosa. Although neoplasm in Meckel's diverticulum is difficult to diagnose preoperatively, the combination of CE and SBE was useful. Based on our search, this is thought to be the first case of neoplasm in Meckel's diverticulum diagnosed endoscopically.