Adenomas arising in Barrett's esophagus.

Three cases of the unusual esophageal adenoma are described. The patients included two men and one woman, with a mean age of 61 years, who presented with dysphagia or heartburn. Histologically, the esophageal adenomas were composed of dysplastic epithelium in a polypoid configuration, similar to adenomas elsewhere in the gastrointestinal tract. All three adenomas arose within Barrett's esophagus (columnar epithelium-lined distal esophagus), and dysplastic Barrett's mucosa was found in the adjacent mucosa of each case. Critical review of the literature identified three additional cases; similar clinicopathologic features were described. Esophageal adenomas are a complication of Barrett's esophagus and are best considered as macroscopic variants of epithelial dysplasia rather than as isolated adenomatous polyps. As such, they likely represent premalignant lesions.