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Korean J Helicobacter  Up Gastrointest Res > Volume 17(3); 2017 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2017;17(3):144-147.
DOI: https://doi.org/10.7704/kjhugr.2017.17.3.144    Published online September 10, 2017.
Esophageal Squamous Cell Carcinoma Presenting as a Subepithelial Tumor
Soon Young Kim, Sang Kil Lee, Hyang Joo Ryu
1Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. sklee@yuhs.ac
2Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
상피하 종양으로 오인된 식도의 진행성 편평상피세포암
김순영1, 이상길1, 류향주2
연세대학교 의과대학 내과학교실1, 병리학교실2
Correspondence:  Sang Kil Lee,
Email: sklee@yuhs.ac
Received: 21 April 2017   • Revised: 19 May 2017   • Accepted: 21 May 2017
Abstract
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.
Key Words: Endoscopy; Esophagus; Squamous cell carcinoma; Subepithelial tumor


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