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Early-detection demo · Esophageal cancer

High-grade dysplasia in long-segment Barrett's — endoscopic cure

Visible 6 mm Paris IIa nodule in the distal Barrett's segment — high-grade dysplasia confirmed on biopsy.

Patient: Frederik · 60 · Barrett's surveillanceModality: EGDRisk: high · 76/100
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01

Risk profile

What OCTON knew before the scan
Risk
76
high
Tier
high
8 cm long-segment Barrett's diagnosed at 52 · GERD × 20 yr · BMI 32 · former smoker · annual EGD with random + targeted biopsies.
Contributing factors
  • Long-segment Barrett's > 3 cm+30
  • Chronic GERD > 5 yr+16
  • Tobacco history+12
  • BMI ≥ 30+8
  • Age 60+6
  • Male sex+4
Narrative

Long-segment Barrett's with HGD is a pre-invasive lesion. Endoscopic mucosal resection + radiofrequency ablation cures > 90% of HGD without esophagectomy.

02

Scan + AI report

What EGD found · High-definition EGD with NBI · Seattle-protocol random + targeted biopsies
EGD · DEMO
Paris IIa · HGD
OCTON · scanning · live
conf 0.85
OCTON Impression · 85% confidence

8 cm salmon-colored mucosa proximal to the GE junction (long-segment Barrett's). NBI-guided biopsy of a 6 mm Paris IIa flat-elevated nodule shows high-grade dysplasia. No frank invasion.

Findings
  • 8 cm long-segment Barrett's salmon mucosa · Distal esophagus
  • 6 mm Paris IIa nodule · 38 cm from incisors · Distal Barrett's
  • Random biopsies negative for invasion outside nodule · Barrett's segment
Differential diagnosis
  • Barrett's HGD (Paris IIa)70%
  • Intramucosal adenocarcinoma (T1a)18%
  • Low-grade dysplasia under-graded8%
  • Reactive epithelial change4%
Recommended actions
  • ▸Endoscopic mucosal resection (EMR) of the 6 mm nodule within 2 weeks
  • ▸Radiofrequency ablation (RFA) of the residual Barrett's segment
  • ▸Expert pathology re-review of HGD diagnosis
  • ▸Repeat EGD at 3 months post-EMR / RFA
Caveats
  • EMR + RFA cures >90% of HGD without esophagectomy.
  • Long-segment Barrett's requires lifelong surveillance even after eradication.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
EGD with Seattle-protocol biopsies
FrequencyEvery 6–12 months (HGD)
Startsage 50
ACG Barrett's 2022
Medical
EMR + RFA for visible dysplasia
FrequencyAs indicated
Startsage 50
NCCN Esophageal v2.2025
Monitoring
Surveillance EGD post-eradication
FrequencyEvery 3 mo Y1, q12 mo lifelong
Startsage 50
ACG Barrett's 2022
04

What changed

The early-detection win

Annual Barrett's surveillance caught a 6 mm Paris IIa HGD nodule — endoscopic mucosal resection + RFA cures the lesion without an esophagectomy.

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