An unexpected complication of prophylactic esophageal stenting: esophageal stent impaction after thread dislocation

A 47-year-old woman was referred to our department with opportunistic endoscopic findings of two submucosal esophageal bulges, approximately half the circumference of the esophagus, both nearly 2.0 cm in size, and 24-27 cm from the incisors. Ultrasound endoscopy diagnosed smooth muscle tumors originating from the muscularis propria layer and she next underwent submucosal tunneling endoscopic resection. Intraoperatively, part of the tumor could not be separated from the muscularis propria layer and a U-shaped tumor was finally resected. A fully covered self-expanding esophageal nitinol stent was then inserted, covering the full circumference esophageal mucosa. The stent was fixed by ears with knotted thread and proton pump inhibitors were given for 1 week. (AU)

An unexpected complication of prophylactic esophageal stenting: esophageal stent impaction after thread dislocation.

A 47-year-old woman was referred to our department with opportunistic endoscopic findings of two submucosal esophageal bulges, approximately half the circumference of the esophagus, both nearly 2.0 cm in size, and 24-27 cm from the incisors. Ultrasound endoscopy diagnosed smooth muscle tumors originating from the muscularis propria layer and she next underwent submucosal tunneling endoscopic resection. Intraoperatively, part of the tumor could not be separated from the muscularis propria layer and a U-shaped tumor was finally resected. A fully covered self-expanding esophageal nitinol stent was then inserted, covering the full circumference esophageal mucosa. The stent was fixed by ears with knotted thread and proton pump inhibitors were given for 1 week.

Dysregulation of hedgehog signaling pathway related components in the evolution of colonic carcinogenesis.

Previous studies report controversial role of Hedgehog (HH) signaling in the progression of colon cancer. This study aimed to investigate the expressions of smoothened (SMO) and downstream glioma-associated oncogene homology-1 (GLI1) in colon cancer, colonic adenoma and normal tissues. Colon cancer and normal tissue samples were collected from 49 patients with colon cancer while colonic adenoma tissue samples were obtained from 34 patients with colonic adenoma. Then the expressions of SMO and GLI1 were investigated using immunohistochemistry (IHC). For the detection of SMO and GLI1 expression, IHC staining results indicated that SMO was mainly expressed on the membrane while GLI1 was mainly expressed in the cytoplasm. The positive rates of SMO and GLI1 protein expressions were significantly increased in colon cancer tissue and colonic adenoma tissue when compared with normal colon tissue. In contrast, the significant difference was not found in the positive rates of SMO and GLI1 protein expressions between colon cancer tissue and colonic adenoma tissue. More importantly, it was found that SMO and GLI1 expressions possibly increased gradually from the normal colon to colonic adenoma to the colon cancer. Furthermore, no distinct correlations were detected between the expression levels of SMO and GLI1 and clinicopathological parameters, including age, gender, differentiation and Dukes stage. The present results provided some new information to the possible role of HH signaling in colon cancer progression. SMO and GLI1 maybe suggested asbiomarkers to identify colon cancerous, precancerous and normal tissues as well astherapeutic targets for colon cancer treatment.