Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8097
Peer-review started: September 15, 2017
First decision: October 10, 2017
Revised: October 25, 2017
Accepted: November 1, 2017
Article in press: November 1, 2017
Published online: December 7, 2017
Processing time: 80 Days and 21.8 Hours
We report the first use of endoscopic submucosal dissection (ESD) for the treatment of a patient with adenoid cystic carcinoma of the esophagus (EACC). An 82-year-old woman visited our hospital for evaluation of an esophageal submucosal tumor. Endoscopic examination showed a submucosal tumor in the middle third of the esophagus. The lesion partially stained with Lugol’s solution, and narrow band imaging with magnification showed intrapapillary capillary loops with mild dilatation and a divergence of caliber in the center of the lesion. Endoscopic ultrasound imaging revealed a solid 8 mm × 4.2 mm tumor, primarily involving the second and third layers of the esophagus. A preoperative biopsy was non-diagnostic. ESD was performed to resect the lesion, an 8 mm submucosal tumor. Immunohistologically, tumor cells differentiating into ductal epithelium and myoepithelium were observed, and the tissue type was adenoid cystic carcinoma. There was no evidence of esophageal wall, vertical stump or horizontal margin invasion with pT1b-SM2 staining (1800 μm from the muscularis mucosa). Further studies are needed to assess the use of ESD for the treatment of patients with EACC.
Core tip: Adenoid cystic carcinoma of the esophagus (EACC) is a rare tumor that may be confused with squamous cell carcinoma and basaloid-squamous cell carcinoma. There is limited data regarding the frequency of metastasis, and the prognosis of patients with this tumor is poor. This is the first report of the use of endoscopic submucosal dissection (ESD) for the treatment of a patient with EACC. ESD may represent an additional treatment option for patients with this disease.