352. A RARE CASE OF ESOPHAGEAL EPIDERMOID METAPLASIA: A POTENTIAL PRECURSOR TO ESOPHAGEAL MALIGNANCY

Abstract A 62-year-old woman with medical history of fibromyalgia and depression was referred to the gastroenterology consultation due to dysphagia for solids for the past 3 months. She had previously performed an upper endoscopy which revealed an esophageal lesion, interpreted as a papillomatous lesion. Upper endoscopy was repeated, showing a whitish, irregular, semi-elevated and hemi-circumferential lesion between 16 and 19cm from the incisors (Figure A and B). Biopsies were performed. Histology revealed a stratified squamous epithelium with mild inflammation, with spongiosis, hyperorthokeratosis and a prominent granular cell layer. This was consistent with esophageal epidermoid metaplasia (Figures C and D). No dysplasia or carcinoma was noted. Esophageal epidermoid metaplasia is a rare condition described only in case reports and small series. It is thought that may be sporadically associated with esophageal squamous cell carcinoma. Endoscopically, this entity might have different appearances such as white plaques, altered texture, keratotic patches, sloughing, granularity, nodularity, furrows, decreased vascularity, and lacy appearance. We report this case to raise awareness for this entity and its association with dysplasia and esophageal cancer. Therefore, in the case of esophageal epidermoid metaplasia lesions a close follow-up or endoscopic treatment may be warranted. Patient is currently on endoscopic surveillance every one year to screen for early dysplasia.