Fuzhou General Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.
Department of Gastroenterology, 900Th Hospital of People's Liberation Army, 156 North Road, West second Ring Road, Gulou District, Fuzhou, 350025, China.
BMC Gastroenterol. 2021 Apr 1;21(1):150. doi: 10.1186/s12876-021-01731-7.
Oesophageal submucosal tumours are usually benign. We report a rare case of esophageal squamous cell carcinoma presenting as a submucosal tumour.
A 58-year-old man undergoing screening oesophago-gastroduodenoscopy was found to have a smooth-surfaced 0.6-cm sized submucosal tumour in the oesophagus 30 cm from the incisor. Endoscopic ultrasonography showed the tumour to be located in the muscularis mucosa; the lesion was heterogeneously hypoechoic and had a clear boundary. With a provisional diagnosis of leiomyoma, the tumour was removed by endoscopic submucosal dissection. Pathological examination showed it to be a moderately differentiated infiltrating squamous cell carcinoma, with normal overlying squamous epithelium. Immunohistochemistry indicated that it was caused by malignant transformation in mucosal glandular duct epithelium. Positron emission tomography-computer tomography showed no tumour spread to any other site. The patient was treated by oesophageal resection.
The clinician should be aware that oesophageal submucosal tumours with smooth overlying mucosa may not always be benign; malignancy must be ruled out.
食管黏膜下肿瘤通常为良性。我们报告一例罕见的食管鳞状细胞癌表现为黏膜下肿瘤。
一名 58 岁男性在接受筛查性食管胃十二指肠镜检查时，于距切牙 30cm 的食管处发现一个光滑表面的 0.6cm 大小黏膜下肿瘤。内镜超声显示肿瘤位于黏膜肌层；病变呈不均匀低回声，边界清晰。基于平滑肌瘤的初步诊断，通过内镜黏膜下剥离术切除了肿瘤。病理检查显示为中分化浸润性鳞状细胞癌，其上覆有正常的鳞状上皮。免疫组织化学显示其是由黏膜腺管上皮的恶性转化引起的。正电子发射断层扫描-计算机断层扫描显示无肿瘤向其他部位扩散。患者接受了食管切除术治疗。
临床医生应意识到，具有光滑黏膜覆盖的食管黏膜下肿瘤并非总是良性的；必须排除恶性肿瘤。
