Multiple recurrences of esophageal adenocarcinoma after esophagectomy

We present a patient with an unusual course of late and multiple recurrences of esophageal adenocarcinoma (EAC) after esophagectomy. A 57-year-old man with longstanding gastroesophageal reflux disease (GERD) underwent screening upper endoscopy in September 2004 and was found to have a 6 cm mass in a 7 cm segment of Barrett’s esophagus (BE). Endoscopic ultrasound (EUS) showed a T2N0 mass and positron emission tomography (PET) scan revealed no distant metastases. Biopsies showed a poorly differentiated EAC of the distal esophagus. He underwent total esophagectomy (post-operatively restaged T3N1M0) followed by adjuvant chemoradiation therapy completed in February 2005