Rajandran A, Sakiris A, John S. Diagnosis and management of a rare case of esophageal epidermoid metaplasia: A case report. World J Gastrointest Endosc 2025; 17(11): 112247 [PMID: 41256292 DOI: 10.4253/wjge.v17.i11.112247]
Corresponding Author of This Article
Arvinf Rajandran, MD, Department of Gastroenterology, Gold Coast University Hospital, 1 Hospital Blvd, Southport 4060, Queensland, Australia. arvinf.rajandran@health.qld.gov.au
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Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 16, 2025 (publication date) through Nov 20, 2025
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World Journal of Gastrointestinal Endoscopy
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1948-5190
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Rajandran A, Sakiris A, John S. Diagnosis and management of a rare case of esophageal epidermoid metaplasia: A case report. World J Gastrointest Endosc 2025; 17(11): 112247 [PMID: 41256292 DOI: 10.4253/wjge.v17.i11.112247]
World J Gastrointest Endosc. Nov 16, 2025; 17(11): 112247 Published online Nov 16, 2025. doi: 10.4253/wjge.v17.i11.112247
Diagnosis and management of a rare case of esophageal epidermoid metaplasia: A case report
Arvinf Rajandran, Anthony Sakiris, Sneha John
Arvinf Rajandran, Anthony Sakiris, Sneha John, Department of Gastroenterology, Gold Coast University Hospital, Southport 4060, Queensland, Australia
Author contributions: Rajandran A lead the conceptualization and drafting of the manuscript; Rajandran A, Sakiris A and John S contributed to the review and editing of all subsequent versions of the manuscript; Rajandran A and Sakiris A contributed to visualisation of the data; John S lead the supervision of the project and validation of the data.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: No conflicts of interest to disclose for all authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvinf Rajandran, MD, Department of Gastroenterology, Gold Coast University Hospital, 1 Hospital Blvd, Southport 4060, Queensland, Australia. arvinf.rajandran@health.qld.gov.au
Received: July 22, 2025 Revised: August 26, 2025 Accepted: September 28, 2025 Published online: November 16, 2025 Processing time: 115 Days and 17.8 Hours
Abstract
BACKGROUND
Esophageal epidermoid metaplasia (EEM) is a rare potentially premalignant oesophageal lesion characterized by a dense granular layer with overlying hyperorthokeratosis resembling the epidermis of skin. Given the low prevalence, data to guide management also remains sparse.
CASE SUMMARY
We highlight a case of a 60-year-old male who presented with gastroesophageal reflux disease symptoms 2 years after an index gastroscopy which showed C0M1 Barrett’s oesophagus. The repeat gastroscopy detected a 15 mm oesophageal epidermoid metaplasia on a background of stable Barrett’s esophagus. This was rather peculiar as the images form his index gastroscopy 2 years prior did not reveal any suspicious oesophageal mucosal abnormality. He underwent a successful endoscopic mucosal resection within 3 months with a surveillance gastroscopy scheduled 6 months later. The cases of confirmed EEM are very low. One study demonstrated out of 1048 consecutive oesophageal biopsies and resections for any indication, only two were EEM (0.19%). It was also noted that the prevalence of epidermoid metaplasia was significantly higher (P < 0.05) in the 58 patients with oesophageal squamous neoplasms, two of whom (3.5%) had concurrent epidermoid metaplasia.
CONCLUSION
This association necessitates careful consideration when determining resection vs surveillance-based management of EEM.
Core Tip: Is there any role as premalignant: A precursor to esophageal squamous cell carcinoma and dysplasia? Esophageal epidermoid metaplasia (EEM) is a rare but potentially premalignant oesophageal lesion. There remains a paucity of data on the formal management of EEM, likely due to the heterogeneity in the presentation, characterisation and detection of EEM. The decision for endoscopic resection vs conservative management is highly individualised. We highlight this case with the aim to increase awareness and detection rate.
