First endoscopic submucosal dissection of gastroesophageal junction carcinoma in a 72-year old male from Saudi Arabia.

INTRODUCTION: Esophageal and gastric tumors are very lethal malignancies. Their most common histology is adenocarcinoma for more than 90% of all gastroesophageal tumors.

CASE PRESENTATION: Herein, we report a case of endoscopic submucosal dissection for gastroesophageal junction carcinoma, the first of its kind to be performed in the Kingdom of Saudi Arabia for a 72-year-old patient, who was found to have a gastroesophageal junction mass extending to the cardia. Complete excision was performed via endoscopic submucosal dissection. There were no complications in the postoperative period and the patient was discharged in good condition.

DISCUSSION: Over time, the management of gastroesophageal junction carcinoma has evolved along with the surgical approach. Endoscopic submucosal dissection preserves the anatomical structures and not only leads to a better quality of life, but also decreases morbidity and mortality. The procedure shows favorable results for early-stage gastroesophageal junction carcinoma as a treatment option with excellent en bloc resection rates.

CONCLUSION: Endoscopic submucosal dissection is an acceptable management for T1 gastroesophageal junction carcinoma.