Department of Endoscopy Center, Shanxi Cancer Hospital, Taiyuan, China.
Department of Pathology, Shanxi Cancer Hospital, Taiyuan, China.
BMC Gastroenterol. 2022 Mar 3;22(1):97. doi: 10.1186/s12876-022-02169-1.
Submucosal oesophageal squamous cell carcinoma is a quite infrequent and special type of oesophageal cancer. Its endoscopic manifestations are similar to those of submucosal oesophageal lesions, so it is easily ignored or misdiagnosed. Thus, the exact and timely diagnosis of oesophageal subepithelial lesions (SELs) is crucial. Endoscopic submucosal dissection (ESD) improves the diagnosis rate of malignant SELs without specific endoscopic presentations.
We report a 63-year-old patient with submucosal lesions of the oesophagus under endoscopy, but CT suggested mediastinal lymphadenectasis. Thus, there was a contradiction between them. After multidisciplinary consultation, endoscopic submucosal dissection (ESD) resection was finally recommended. The lesion was completely resected by endoscopic submucosal dissection. Postoperative pathology reported poorly differentiated squamous cell carcinoma, and subsequent PET-CT examination provided clarity, revealing mediastinal lymph node metastasis.
Not all oesophageal SELs are benign, and a small number of SELs can be malignant. Submucosal oesophageal squamous cell carcinoma is a rare disease that may be characterized by oesophageal subepithelial lesions (SELs). Therefore, the precise and timely diagnosis of SELs is essential. If it is necessary to obtain lesion tissue for a definite diagnosis, ESD with less invasiveness is an excellent choice.
食管黏膜下鳞状细胞癌是一种罕见且特殊的食管癌类型。其内镜表现与食管黏膜下病变相似，因此易被忽视或误诊。因此，准确及时地诊断食管黏膜下上皮下病变（SELs）至关重要。内镜黏膜下剥离术（ESD）提高了无特殊内镜表现的恶性 SELs 的诊断率。
我们报告了一例 63 岁患者，内镜下发现食管黏膜下病变，但 CT 提示纵隔淋巴结肿大。因此，两者之间存在矛盾。经多学科会诊，最终推荐行内镜黏膜下剥离术（ESD）切除。病变完全经内镜黏膜下剥离术切除。术后病理报告为低分化鳞状细胞癌，随后的 PET-CT 检查明确显示纵隔淋巴结转移。
并非所有食管 SELs 均为良性，少数 SELs 可能为恶性。食管黏膜下鳞状细胞癌是一种罕见疾病，可能以食管黏膜下上皮下病变（SELs）为特征。因此，准确及时地诊断 SELs 至关重要。如果需要获取病变组织以明确诊断，微创的 ESD 是一个很好的选择。
