A superficial esophageal cancer in an epiphrenic diverticulum treated by endoscopic submucosal dissection
- PMID: 28784105
- PMCID: PMC5547519
- DOI: 10.1186/s12876-017-0649-y
A superficial esophageal cancer in an epiphrenic diverticulum treated by endoscopic submucosal dissection
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.
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.
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References
-
- 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
-
- 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
-
- 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
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