Esophageal Squamous Cell Carcinoma Presenting as a Subepithelial Tumor

Kim, Soon Young; Lee, Sang Kil; Ryu, Hyang Joo

doi:2017.17.3.144

Korean J Helicobacter Up Gastrointest Res > Volume 17(3); 2017 > Article

Case Report

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