Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1336-1342
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1336
Esophageal superficial adenosquamous carcinoma resected by endoscopic submucosal dissection: A rare case report
Guan-Yi Liu, Ji-Xin Zhang, Long Rong, Wei-Dong Nian, Bi-Xiao Nian, Yuan Tian
Guan-Yi Liu, Long Rong, Wei-Dong Nian, Bi-Xiao Nian, Yuan Tian, Endoscopy Center, Peking University First Hospital, Beijing 100032, China
Ji-Xin Zhang, Department of Pathology, Peking University First Hospital, Beijing 100032, China
Author contributions: Liu GY, Nian WD, Nian BX and Tian Y planned the treatment strategy; Nian WD performed the operation; Zhang JX performed and analyzed the pathological tests; Liu GY and Zhang JX drafted the manuscript; Rong L and Nian WD conducted the research and revised the manuscript for important intellectual content; All authors read and approved the final manuscript.
Supported by Scientific Research Seed Fund of Peking University First Hospital, No. 2019SF20.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wei-Dong Nian, MBChB, Professor, Endoscopy Center, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100032, China.
Received: August 22, 2020
Peer-review started: August 22, 2020
First decision: December 14, 2020
Revised: December 15, 2020
Accepted: December 27, 2020
Article in press: December 27, 2020
Published online: February 26, 2021

Adenosquamous carcinoma (ASC), which is comprised of squamous cell carcinoma (SCC) and adenocarcinoma elements, is a rare histological type of esophageal carcinoma. Few reports have focused on the endoscopic findings and the effectiveness of the endoscopic treatment of early ASC.


A 77-year-old man underwent esophagogastroduodenoscopy for heartburn. A flat lesion with an uneven and slightly elevated central portion was found in the distal esophagus. Magnifying endoscopy with narrow-band imaging showed a well-demarcated brownish area with dendritically branched abnormal vessels and highly irregular intrapapillary capillary loops. A histopathological diagnosis of SCC was obtained by endoscopic biopsy. Endoscopic ultrasonography revealed a hypoechoic mass confined to the mucosa layer. The lesion was suspected to be SCC with invasion into the muscularis mucosa. The lesion was resected en bloc by endoscopic submucosal dissection and histologically diagnosed as esophageal ASC limited within the muscularis mucosa, which was completely resected without lymphovascular or neural invasion. The SCC element was the pre-dominant element. The adenocarcinoma element formed ductal and nested structures distributed in a focal pattern. The patient underwent only endoscopic submucosal dissection and has been under annual endoscopic and radiographic surveillance for 3 years without recurrence.


For early ASC confined within the mucosal layer, complete endoscopic resection might also be a curative treatment.

Keywords: Adenosquamous carcinoma, Esophageal neoplasms, Endoscopy, Narrow band imaging, Endoscopic submucosal dissection, Case report

Core Tip: Adenosquamous carcinoma is a rare type of esophageal carcinoma and is often identified as advanced tumors, which are managed by surgery. Here, we report a case of early adenosquamous carcinoma mimicking squamous cell carcinoma during endoscopy examination that was successfully treated by endoscopic resection, suggesting that for very early adenosquamous carcinoma endoscopic resection alone might be a sufficient treatment, as in squamous cell carcinoma.