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

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.

Publikationsverlauf

Artikel online veröffentlicht:
23. Dezember 2022

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