Frontiers in oncology · 2026
Esophageal submucosal gland duct adenoma: a case report and pooled analysis of demographic differences between eastern and western populations.
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Chen Yuhua, Zhang Yafei, Ge Liuqing
Аннотация
BACKGROUND: Esophageal submucosal gland duct adenoma (ESGDA) is an exceptionally rare benign tumor. Classic teaching suggests a predilection for the upper and mid esophagus. This study reports a new case and performs a comparative literature analysis to test for potential geographic variations.
CASE INTRODUCTION: A 61-year-old Asian male was found to have a 1.6 cm submucosal tumor in the distal esophagus during a routine check-up. The lesion was successfully resected via endoscopic submucosal dissection (ESD), with pathological confirmation of ESGDA.
METHODS: We conducted a pooled analysis of 20 well-documented ESGDA cases from the literature. Cases were stratified into an Eastern cohort (n=10) and a Western cohort (n=10) based on the first author's affiliation. Demographic and tumor characteristics were systematically compared. Given the small sample size, Fisher's exact test was applied for categorical variable comparisons.
RESULTS: Striking differences were observed. The Eastern cohort exhibited a profound male predominance (9:1 male-to-female ratio), whereas the Western cohort had a balanced sex distribution (1:1). Fisher's exact test for this comparison yielded a two-sided P value of 0.141. Tumor location also differed dramatically: 100% of Eastern cases were located in the distal esophagus/gastroesophageal junction, compared to only 40% of Western cases, with 60% of Western cases found in the mid or upper esophagus, a pattern not seen in the Eastern cohort (Fisher's exact test, P = 0.011). Mean age and tumor size were similar between groups.
CONCLUSION: The clinical presentation of ESGDA demonstrates notable geographic patterns. In this analysis, Eastern cases presented exclusively in the distal esophagus with a strong male predominance, while Western cases showed a broader anatomical distribution and a balanced sex ratio. These descriptive findings suggest potential population-specific differences. Clinicians should be aware of these patterns, and future studies with larger sample sizes are warranted for confirmation.
CASE INTRODUCTION: A 61-year-old Asian male was found to have a 1.6 cm submucosal tumor in the distal esophagus during a routine check-up. The lesion was successfully resected via endoscopic submucosal dissection (ESD), with pathological confirmation of ESGDA.
METHODS: We conducted a pooled analysis of 20 well-documented ESGDA cases from the literature. Cases were stratified into an Eastern cohort (n=10) and a Western cohort (n=10) based on the first author's affiliation. Demographic and tumor characteristics were systematically compared. Given the small sample size, Fisher's exact test was applied for categorical variable comparisons.
RESULTS: Striking differences were observed. The Eastern cohort exhibited a profound male predominance (9:1 male-to-female ratio), whereas the Western cohort had a balanced sex distribution (1:1). Fisher's exact test for this comparison yielded a two-sided P value of 0.141. Tumor location also differed dramatically: 100% of Eastern cases were located in the distal esophagus/gastroesophageal junction, compared to only 40% of Western cases, with 60% of Western cases found in the mid or upper esophagus, a pattern not seen in the Eastern cohort (Fisher's exact test, P = 0.011). Mean age and tumor size were similar between groups.
CONCLUSION: The clinical presentation of ESGDA demonstrates notable geographic patterns. In this analysis, Eastern cases presented exclusively in the distal esophagus with a strong male predominance, while Western cases showed a broader anatomical distribution and a balanced sex ratio. These descriptive findings suggest potential population-specific differences. Clinicians should be aware of these patterns, and future studies with larger sample sizes are warranted for confirmation.