Endoscopic Resection of Regressed Early Esophageal Cancer: Report of a Case

Abstract

Regression of cancerous ulcers is unusual, but when it does occur, it is often associated with early gastric cancer (EGC). This entire process of growth and regression is referred to as a malignant cycle. Here, we describe the clinical course of a patient with early esophageal cancer (EEC) presenting an ulcer, which regressed in the follow-up period. The lesion was located in the esophagus, 38 cm from the incisor. and reflux esophagitis was also present. The concept of acid reflux induced malignant cycle may be the reason. Endoscopic ultrasonography (EUS) usually has good sensitivity and specificity in determining the TN stage. In this case, endoscopic submucosal dissection (ESD) was performed, even though EUS before treatment suggested the involvement of the muscularis propria (MP) layer. Complete resection was achieved without MP layer involvement. Possible reasons for the overstaging of EUS included focal inflammation of early esophageal cancer, over-inflation of the water-filled balloon surrounding the ultrasound transducer, and an imprecise localization of a small, non-circumferential neoplasm.In conclusion, for early esophageal cancer, ESD may be an option in cases where the esophagus can be preserved, and is a potential treatment for early esophageal cancer.