Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2017 Aug 7;17(1):94.
doi: 10.1186/s12876-017-0649-y.

A superficial esophageal cancer in an epiphrenic diverticulum treated by endoscopic submucosal dissection

Kuangi Fu  1   2 , Peng Jin  3 , Yuqi He  3 , Masanori Suzuki  4 , Jianqiu Sheng  3
Affiliations
Case Reports

A superficial esophageal cancer in an epiphrenic diverticulum treated by endoscopic submucosal dissection

Kuangi Fu et al. BMC Gastroenterol. .

Abstract

Background: We report a unique case of a superficial esophageal cancer arising in a single diverticulum, diagnosed with magnifying image-enhanced endoscopy and then successfully treated by endoscopic submucosal dissection (ESD).

Case presentation: A 66-year-old man with alcohol-related liver injury visited our hospital for endoscopy for investigation of varix. Esophagogastroduodenoscopy showed no varix but a large epiphrenic diverticulum with an area of fainted redness just above the esophagogastric junction. Narrow band imaging revealed a sharply demarcated brownish dotted area, and dilated intra-epithelial papillary capillary loops (IPCL) were subsequently seen after magnification. Chromoendoscopy with 1% Lugol's iodine solution demonstrated a well-demarcated unstained area, approximately 20 mm in diameter. Endoscopic biopsy revealed a squamous cell carcinoma (SCC).

Conclusion: The tumor was completely resected by ESD without perforation. Histologically, it was an intraepithelial SCC without lympho-vascular invasion of cancer cells. No local recurrence or metastasis was detected at the last follow-up of 42 months.

Keywords: Endoscopic submucosal dissection; Epiphrenic diverticulum; Magnifying endoscopy; Narrow band imaging; Superficial esophageal cancer.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Written consent was obtained from the patient. As a case report, approval from the institutional review board was not needed.

Consent for publication

Written informed consent was obtained from the patient for publication of this case report.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a A large epiphrenic diverticulum just above the esophagogastric junction was seen during esophagogastroduodenoscopy. b An area of fainted redness was detected with white light endoscopy at the bottom of the diverticulum
Fig. 2
Fig. 2
a NBI revealed a demarcated brownish dotted area before magnification. b Dilated intra-epithelial papillary capillary loops (IPCL) were seen after magnifying NBI
Fig. 3
Fig. 3
At the bottom of the diverticulum, chromoendoscopy with 1% Lugol’s iodine solution demonstrated a well-demarcated unstained area, approximately 20 mm in diameter
Fig. 4
Fig. 4
Mucosal defect after ESD was shown and no definite perforation was seen endoscopically
Fig. 5
Fig. 5
White light endoscopy showed no local recurrence 42 months after ESD
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Benacci JC, Deschamps C, Trastek VF, Allen MS, Daly RC, Pairolero PC. Epiphrenic diverticulum: results of surgical treatment. Ann Thorac Surg. 1993;55:1109–1113. doi: 10.1016/0003-4975(93)90016-B. - DOI - PubMed
    1. Honda H, Kume K, Tashiro M, Sugihara Y, Yamasaki T, Narita R, et al. Early stage esophageal carcinoma in an epiphrenic diverticulum. Gastrointest Endosc. 2003;57:980–982. doi: 10.1016/S0016-5107(03)70042-X. - DOI - PubMed
    1. Muto M, Minashi K, Yano T, Saito Y, Oda I, Nonaka S, et al. Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. J Clin Oncol. 2010;28:1566–1572. doi: 10.1200/JCO.2009.25.4680. - DOI - PMC - PubMed
    1. Oyama T, Inoue H, Arima M, Momma K, Omori T, Ishihara R, et al. Prediction of the invasion depth of superficial squamous cell carcinoma based on microvessel morphology: magnifying endoscopic classification of the Japan esophageal society. Esophagus. 2017;14:105–112. doi: 10.1007/s10388-016-0527-7. - DOI - PMC - PubMed
    1. Shimizu Y, Omori T, Yokoyama A, Yoshida T, Hirota J, Ono Y, et al. Endoscopic diagnosis of early squamous neoplasia of the esophagus with iodine staining: high-grade intra-epithelial neoplasia turns pink within a few minutes. J Gastroenterol Hepatol. 2008;23:546–550. doi: 10.1111/j.1440-1746.2007.04990.x. - DOI - PubMed

Publication types

MeSH terms