Adenocarcinoma in Barrett's Columnar-Lined Esophagus

Adenocarcinoma occurred in the aberrant columnar epithelium of the distal esophagus of a 62-year-old man. Symptomatic history was vague but evaluation of a filling defect in the distal esophagus on an upper-gastrointestinal tract series led to esophagoscopy and biopsy. The case emphasizes the unexpected, benign presentation that may be associated with Barrett's esophagus and also draws attention to its association with adenocarcinoma. The experimental evidence includes two theories for the etiology of Barrett's esophagus.