# A case report of Barrett's esophageal adenocarcinoma in a young adult aged 20 years

## TL;DR

A 20-year-old Japanese woman was diagnosed with Barrett's esophageal adenocarcinoma, a rare condition in young adults, and successfully treated with endoscopic submucosal dissection.

## Contribution

This case report highlights the rare occurrence of Barrett's esophageal adenocarcinoma in a young adult and emphasizes the importance of surveillance in high-risk individuals.

## Key findings

- Barrett's esophageal adenocarcinoma was diagnosed in a 20-year-old Japanese woman.
- The tumor was classified as pT1a-DMM and successfully treated with curative resection.
- The case underscores the need for surveillance in young adults with risk factors like obesity and acid exposure.

## Abstract

In Japan, the prevalence of Barrett's esophageal adenocarcinoma (BEA) has recently increased owing to a decrease in the number of patients with Helicobacter pylori infection, westernization of the diet, and an increase in obesity prevalence. However, BEA in patients in their 20s is extremely rare. Our patient was a 20‐year‐old Japanese woman with chief complaints of vomiting and nausea. Esophagogastroduodenoscopy was performed to investigate the cause of vomiting, and a raised lesion was found in the gastroesophageal junctional zone. In the magnified observation, the mucosal pattern of the lesion was partially invisible, and the vascular pattern was irregular; the lesion was diagnosed based on the Japan Esophageal Society classification for Barrett's esophagus ‐related superficial neoplasia. Endocytoscopic observations revealed a highly irregular glandular structure. Computed tomography showed no distant metastasis. Based on these results, we diagnosed BEA as short‐segment Barrett's esophagus and performed an endoscopic submucosal dissection. The pathological diagnosis was pT1a‐DMM. It was a well‐differentiated adenocarcinoma and was treated with curative resection.

BEA is extremely rare in young adults in their 20s. Nonetheless, appropriate surveillance is required for patients with multiple risk factors, including obesity and exposure to acid and bile resulting from persistent vomiting.