Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1336
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.
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.