Esophageal Squamous Cell Carcinoma Presenting as a Subepithelial Tumor
Korean J Helicobacter Up Gastrointest Res 2017;17(3):144-147
Published online September 10, 2017
© 2017 Korean College of Helicobacter and Upper Gastrointestinal Research.

Soon Young Kim1, Sang Kil Lee1, Hyang Joo Ryu2

Departments of Internal Medicine1 and Pathology2, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: Sang Kil Lee
Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2228-1996, Fax: +82-2-393-6884, E-mail:
Received April 21, 2017; Revised May 19, 2017; Accepted May 21, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Esophageal squamous cell carcinoma (ESCC) presenting as subepithelial tumor-like growth is a very rare form of the disease. We report a case of primary ESCC with intramural growth, covered with normal esophageal epithelium. The patient was initially referred due to a subepithelial tumor at the mid-esophagus, butendoscopic ultrasonography revealed a heterogeneously hypoechoic mass, which disrupted the structure of the muscularis propria. An endoscopic submucosal dissection was performed for accurate diagnosis, and the lesion was diagnosed histopathologically as moderately differentiated squamous cell carcinoma. Computed tomography revealed an enlarged left upper paratracheal lymph node, which showed increased uptake on positron emission tomography. The patient underwent subtotal esophagectomy with total mediastinal lymphadenectomy and adjuvant chemotherapy. Primary ESCC with intramural growth is extremely rare. For accurate diagnosis, when there is a high index of suspicion, additional investigations such as endoscopic ultrasonography or diagnostic endoscopic submucosal dissection might be needed.
Keywords : Endoscopy; Esophagus; Squamous cell carcinoma; Subepithelial tumor

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