{"id":5463,"date":"2019-07-02T08:34:15","date_gmt":"2019-07-02T06:34:15","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/bildergalerie\/barrett-karzinom-an-der-z-linie\/"},"modified":"2020-10-21T08:13:14","modified_gmt":"2020-10-21T06:13:14","slug":"barrett-karzinom-an-der-z-linie","status":"publish","type":"bildergalerie","link":"https:\/\/www.endoscopy-campus.com\/en\/bildergalerie\/barrett-karzinom-an-der-z-linie\/","title":{"rendered":"Barrett\u2019s carcinoma at the Z-line"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\"><em>Patient history<\/em><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Presentation, for a second opinion, of a 47-year-old male patient with multiple morbidities, in whom an early Barrett\u2019s carcinoma had previously been removed using endoscopic mucosal resection (EMR) at an external hospital (pT1b, pL0, pL0, pV0, pR1 also at base). Despite the R1 situation at the base and the patient\u2019s age, a surgical intervention had not been carried out due to the patient\u2019s poor general condition and concomitant conditions.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-01.png\" alt=\"\" class=\"wp-image-5442\"\/><figcaption>Findings before EMR, with a clearly polypoid lesion at the Z-line.<\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-02.png\" alt=\"\" class=\"wp-image-5444\"\/><figcaption>Findings during the EMR previously carried out at another hospital, with insufficient ablation at the base already visible macroscopically.<\/figcaption><\/figure><\/div>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><em>Endoscopic images<\/em><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">There was an initially noticeable bulge at the Z-line; on closer examination, an irregular central area was then seen, with a suspicion of undermining growth under the squamous epithelium.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"480\" height=\"360\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-03.png\" alt=\"\" class=\"wp-image-5446\"\/><\/figure><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><em>Endoscopic therapy<\/em><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The planned endoscopic resection starts with marking of the lesion with a sufficient safety margin.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-04.png\" alt=\"\" class=\"wp-image-5448\"\/><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-05.png\" alt=\"\" class=\"wp-image-5450\"\/><\/figure><\/div>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Status post endoscopic submucosal dissection (ESD), including all markings.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-06.png\" alt=\"\" class=\"wp-image-5452\"\/><\/figure><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><em>Histology<\/em><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Submucosal invasion by a T1b carcinoma (sm1, max. 160&nbsp;\u00b5m), L0, V0, R0, G1, with growth partly undermining the squamous epithelium.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><em>Further procedure<\/em><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Presentation of the case at the interdisciplinary tumor board. Surgery was not planned, due to the patient\u2019s multiple morbidities. Follow-up (with endoscopy and CT).<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/www.endoscopy-campus.com\/wp-content\/uploads\/Barrett-Karzinom-an-der-Z-Linie-07.png\" alt=\"\" class=\"wp-image-5454\"\/><figcaption><strong>Check-up, 6 months after ESD:<\/strong> No macroscopic or histological signs of recurrence; no suspicious lymph nodes on the CT.<\/figcaption><\/figure><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Konsiliarische Vorstellung eines 47-J\u00e4hrigen, multimorbiden Patienten bei dem in einem externen Krankenhaus zuvor mittels EMR ein Barrettfr\u00fchkarzinom abgetragen wurde. Trotz der basalen R1 Situation und des Patientenalters aufgrund des reduzierten AZ und der Begleiterkrankungen keine chirurgische Intervention. <\/p>\n","protected":false},"featured_media":5441,"template":"","categories":[97,171],"tags":[1763,1765,1764,58],"ec-magazin-ausgaben":[],"sponsoren-erwaehnung":[],"autor":[],"class_list":["post-5463","bildergalerie","type-bildergalerie","status-publish","has-post-thumbnail","hentry","category-literature","category-special-cases","tag-barrett-karzinom-en","tag-barretts-carcinoma","tag-barrettfruehkarzinom-en","tag-z-line"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/bildergalerie\/5463","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/bildergalerie"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/bildergalerie"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media\/5441"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=5463"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=5463"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=5463"},{"taxonomy":"ec-magazin-ausgaben","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-magazin-ausgaben?post=5463"},{"taxonomy":"sponsoren-erwaehnung","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/sponsoren-erwaehnung?post=5463"},{"taxonomy":"autor","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/autor?post=5463"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}