Volume 1, Issue 4, Pages (December 2016)

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Volume 1, Issue 4, Pages 78-81 (December 2016) Radiofrequency ablation is a treatment option for early stages of verrucous esophageal carcinoma Richard F. Knoop, MD, Hans-Juergen Richter-Schrag, MD, Steffen Heeg, MD, Jens Hoeppner, MD, Andreas Fischer, MD VideoGIE Volume 1, Issue 4, Pages 78-81 (December 2016) DOI: 10.1016/j.vgie.2016.09.008 Copyright © 2016 The Authors Terms and Conditions

Figure 1 Upper endoscopic view before operation, showing a thickened, contact-vulnerable, exophytic, and lumen-constricting verrucous mass in the esophagus over a distance of 15 cm (asterisk = esophageal lumen). (From Kulemann B, Fischer A, Hoeppner J. Esophageal stenosis caused by a rare entity. Gastroenterology 2014;146:618-871. Used with permission.) VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 2 CT scans with contrast enhancement showing long-segment thickening of the thoracic esophagus (arrows) without signs of lymphadenopathy or metastases. VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 3 Surgical specimen with hyperkeratotic, exophytic growth of the tumor (arrow) and normal esophageal tissue (asterisk). (From Kulemann B, Fischer A, Hoeppner J. Esophageal stenosis caused by a rare entity. Gastroenterology 2014;146:618-871. Used with permission.) VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 4 Microscopic view of verrucous esophageal carcinoma showing invasive characteristics (arrow). (From Kulemann B, Fischer A, Hoeppner J. Esophageal stenosis caused by a rare entity. Gastroenterology 2014;146:618-871. Used with permission.) VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 5 Early disseminated recurrence of verrucous carcinoma in the remaining esophagus 22 months after esophageal resection with intrathoracic esophagogastrostomy. VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 6 Endoscopic radiofrequency ablation with use of a Barrx 90 RFA Focal Catheter. VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 7 First local recurrence limited strictly to the anastomotic site 6 months after radiofrequency ablation (arrows). VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 8 Persistent local recurrence limited strictly to the anastomotic site (arrows) after additional argon-plasma coagulation by use of a MABS-GIT probe. VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions

Figure 9 The main part of the initially affected esophagus has remained free of tumor 18 months after radiofrequency ablation. VideoGIE 2016 1, 78-81DOI: (10.1016/j.vgie.2016.09.008) Copyright © 2016 The Authors Terms and Conditions