Long-Term Endoscopic Management of Recurrent High-Grade Dysplasia and Intramucosal Carcinoma in an Inoperable Barrett Patient
Recommended Citation
Alharami M, Anbar A, Suleiman Z, Alali M, Hemaidan H. Long-Term Endoscopic Management of Recurrent High-Grade Dysplasia and Intramucosal Carcinoma in an Inoperable Barrett Patient. ACG Case Rep J. 2026;13(5):e02129.
Document Type
Article
Publication Date
5-1-2026
Publication Title
ACG Case Rep J
Abstract
Barrett esophagus (BE) with progression to high-grade dysplasia (HGD) or intramucosal carcinoma (IMC) presents a management challenge in patients unfit for surgery. Endoscopic eradication therapies, including radiofrequency ablation (RFA), endoscopic mucosal resection (EMR), and cryotherapy, offer minimally invasive alternatives. This report describes a decade-long course of recurrent HGD and IMC managed entirely through endoscopic interventions in a patient with severe chronic obstructive pulmonary disease, emphasizing the value of personalized and sequential therapeutic strategies. A 71-year-old man with BE and severe chronic obstructive pulmonary disease underwent 18 endoscopic interventions over 10 years, including 5 EMRs, 6 RFAs, and 7 cryotherapy sessions. Despite repeated RFA and EMR, dysplasia recurred multiple times. Cryotherapy initiated after RFA failure achieved complete eradication of dysplasia, intestinal metaplasia, and carcinoma in situ. The patient maintained remission for more than 3 years without recurrence. This case highlights the feasibility of long-term endoscopic management of recurrent HGD and IMC in nonsurgical candidates.
PubMed ID
42147439
Volume
13
Issue
5
First Page
02129
Last Page
02129
