A case of Barrett’s Esophageal Adenocarcinoma associated with heterotopic pancreas

A 56-year-old man was referred to our hospital because of the detection of esophageal adenocarcinoma at a local hospital. Endoscopy showed an elevated lesion in the lower esophagus. We diagnosed this lesion as early esophageal carcinoma and performed video-assisted distal esophagectomy. On microscopic examination, a 6.0-cm irregular elevated lesion with a cavity lesion was identified at the lower esophagus. This lesion corresponded to well- to moderately differentiated adenocarcinoma with invasion to the submucosa. In the cavity lesion, mucosal glands and pancreatic tissue were detected. The surrounding esophageal mucosa showed Barrett’s epithelium with high-grade intraepithelial neoplasia and adenocarcinoma. The lesion was diagnosed as Barrett’s esophageal adenocarcinoma at T1b, N2, M0: Stage II. The patient is alive and well without recurrence 5 years after surgery. Esophageal heterotopic pancreas is a congenital condition that is exceedingly rare. In this case, heterotopic pancreas and its surrounding cavity lesion were considered to have led to the onset of Barrett’s esophagus and its progression to adenocarcinoma.