A case of two Barrett esophageal adenocarcinomas arising in a long-segment Barrett esophagus and esophagogastric junction adenocarcinoma

A 36-year-old man with two different foci of Barrett esophageal adenocarcinoma arising in a long-segment Barrett esophagus (LSBE) and esophagogastric junction adenocarcinoma underwent thoracoscopic esophagectomy, handassisted laparoscopic proximal gastrectomy with 2-field lymph node dissection and reconstruction using a gastric tube through the posterior mediastinum. Histopathological findings of the lesions demonstrated two welldifferentiated adenocarcinomas considered to have arisen from LSBE associated with dysplasia and hepatoid adenocarcinoma. Immunohistochemical analysis of mucin phenotype revealed different results for these three foci. However, we could not determine their origins by mucin immunoreactivity of the tumor surrounding the mucosa. The patient has survived with no recurrence and has been observed for 12 months after surgery. The low frequency of LSBE makes this disease difficult to characterize. We suggest, a detailed histopathological examination is essential in providing important information to understand esophagogastric junction cancer and/or Barrett esophageal carcinoma.