GEJ Adenocarcinoma Following Antireflux Surgery: A Missed Diagnosis

TL;DR

This paper discusses a rare case of gastroesophageal junction adenocarcinoma that was missed despite prior antireflux surgery and endoscopy.

Contribution

The novelty lies in highlighting the potential for missed diagnosis of GEJ adenocarcinoma following antireflux surgery.

Findings

Antireflux surgery does not prevent the development of esophageal adenocarcinoma.

A case of GEJ adenocarcinoma was missed during a recent endoscopy despite prior surgical intervention.

Recurrent symptoms post-surgery may indicate an underlying malignancy.

Abstract

Adenocarcinoma of the gastroesophageal junction is a rare condition with no specific screening guidelines. While fundoplication is the surgical treatment of choice for gastroesophageal reflux disease, many patients continued to have recurrent symptoms postprocedure with several structural complications after. Antireflux surgery does not prevent esophageal adenocarcinoma. We present a case of a 76-year-old woman with a history of severe gastroesophageal reflux disease and hiatal hernia treated with repeat fundoplication who presented with progressively and rapidly worsening dysphagia to solids and liquids. The patient was found to have a poorly differentiated adenocarcinoma at the gastroesophageal junction, when the esophagogastroduodenoscopy 2 months had missed the diagnosis.

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