case_images: PMC11827482_01
case_images: (a) Endoscopic image of the esophageal squamous cell carcinoma treated with the initial endoscopic submucosal dissection. (b) Histopathological examination of the resected lesion showed well-differentiated squamous cell carcinoma in the epithelium (HE x40). (c) A circumferential elevated lesion with hyperkeratosis was located in the mid-thoracic esophagus during its initial detection. (d) Endoscopic image of the lesion 2 years after its initial detection.
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case_images: A 70-year-old man underwent endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma located 30-33 cm from the incisors (Figure 1a, b). Two years after the first ESD, surveillance endoscopy revealed a circumferential, raised, slightly nodular esophageal lesion with hyperkeratosis at the mid-esophagus, located 33-38 cm from the incisors (Figure 1c). The lesion demonstrated a gradual extension trend over the past 4 years (Figures 1c,d and 2a).
case_images: (a) Endoscopic image of the lesion before the second endoscopic submucosal dissection. (b) NBI showed hyperkeratosis and no internal vessel. (c) Magnified narrow-band imaging showed no internal vessel. (d) Chromoendoscopy with Lugol staining showed an unstained area.
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case_images: The lesion demonstrated a gradual extension trend over the past 4 years (Figures 1c,d and 2a). Magnifying endoscopy with narrow-band imaging revealed no significant vascularity on the surface of the lesion (Figure 2b,c). Chromoendoscopy with Lugol staining revealed an unstained area of the lesion (Figure 2d).
case_images: (a, b) Surrounding superficial esophageal cancer resected en bloc by endoscopic submucosal dissection. (c) The gross macroscopic image of the resected specimen. (d) Red lines map tumor cells.
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case_images: Thus, a second ESD was performed 6 years after the first ESD for diagnosis (Figure 3a-d).
case_images: (a) A histopathological examination of the resected lesion showed squamous cell carcinoma and Candida proliferates at the epithelial layer (HE x20). (b) Histopathological examination showed Candida proliferates at the epithelial layer (D-PAS x500). (c) The carcinoma showed infiltrative growth (HE x100). (d) Histopathological examination of the resected lesion did not involve lympho-vascular invasion (desmin x250).
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case_images: Histopathological examination revealed Candida proliferates at the epithelial layer, epithelial parakeratosis, and well-differentiated squamous cell carcinoma in the epithelium and lamina propria mucosae, consistent with a raised lesion (pT1aN0M0 pStage1A; Figure 4a,b). The carcinoma showed infiltrative growth (Figure 4c). The squamous cell carcinoma did not extend beyond the lamina propria mucosae, had clear horizontal and vertical margins, and did not involve lympho-vascular invasion (Figure 4d).