Exploration of preventive treatment for high risk patients with metachronous multiple esophageal squamous cell carcinoma: A case report.

IF 3.2 Q3 ONCOLOGY

World journal of clinical oncology Pub Date : 2025-08-24 DOI:10.5306/wjco.v16.i8.108371

Dan Chen, Ding-Fu Zhong, Dong Liu

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引用次数: 0

Abstract

Background: Metachronous multiple esophageal squamous cell carcinomas (ESCCs) may occur in some patients after endoscopic resection. Multiple dysplastic lesions in the esophagus increase risk of multiple squamous cell carcinomas (SCCs). Endoscopic imaging technology such as narrow band imaging (NBI), can detect early SCC. Lugol chromoendoscopy is also the conventional standard technique for detecting superficial ESCC. However, little is known about the interval from the first SCC to the metachronous SCC. Effective methods to prevent multiple metachronous SCCs are needed in survivors of esophageal SCC.

Case summary: A 56-year-old man showed a slightly elevated reddish area in the middle thoracic esophagus at 30 cm from the incisors on gastroscopy for routine examination. Esophageal mucosa lesion was about 2.5 cm. NBI and magnifying gastroscopy confirmed intra-epithelial papillary loop type B-1 according to the Japan Esophageal Society Classification. Lugol chromoendoscopy was used to evaluate the dysplastic squamous epithelium in the esophagus. Biopsy pathology revealed severe dysplastic squamous epithelium. Computed tomography showed no lymph node metastasis. His complete blood test and tumor markers were within reference values. He had no history of alcohol consumption and smoking. Mucosal lesion was dissected by endoscopic submucosal dissection (ESD). Postoperative pathological results showed moderately differentiated squamous carcinoma. No cancer thrombus was seen in the vasculature, and the surrounding cut edge was not involved. The patient underwent radiotherapy within 2 months after ESD. The multiple Lugol-voiding lesions disappeared, and enhanced chest computed tomography revealed no lymph node metastasis.

Conclusion: This is the first case of multiple dysplastic lesions of esophagus cured by radiotherapy. Radiotherapy after minimally invasive endoscopic treatment might be a safe and effective optional therapeutic strategy to prevent metachronous multiple esophageal SCCs.

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异时性多发食管鳞状细胞癌高危患者的预防治疗探讨1例。

背景：异时性多发性食管鳞状细胞癌（ESCCs）可能发生在一些患者内镜切除后。食管多发发育不良病变增加多发性鳞状细胞癌（SCCs）的风险。内镜成像技术，如窄带成像（NBI），可以发现早期SCC。Lugol色内窥镜也是检测浅表ESCC的常规标准技术。然而，从第一次SCC到同步SCC的时间间隔知之甚少。食管鳞状细胞癌幸存者需要有效的方法来预防多发异时性鳞状细胞癌。病例总结：56岁男性，在常规胃镜检查时，在距门牙30cm处发现胸中食道微隆起的红色区域。食管黏膜病变约2.5 cm。NBI和胃镜放大证实上皮内乳头状袢B-1型，符合日本食管学会分类。采用Lugol染色内镜检查食管鳞状上皮发育不良。活检病理显示鳞状上皮发育严重异常。计算机断层扫描未见淋巴结转移。全血检查及肿瘤指标均在参考值范围内。他没有饮酒和吸烟史。内镜下粘膜下剥离术（ESD）对粘膜病变进行剥离。术后病理结果为中分化鳞癌。血管内未见癌栓，周围切边未受累。患者在ESD术后2个月内接受放疗。多发lugol -排尿病变消失，胸部增强ct未见淋巴结转移。结论：这是首例放疗治疗食管多发发育不良的病例。微创内镜治疗后放射治疗可能是预防异时性多发食管鳞状细胞癌安全有效的可选治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World journal of clinical oncology ONCOLOGY-

自引率

0.00%

发文量

585

期刊介绍： The WJCO is a high-quality, peer reviewed, open-access journal. The primary task of WJCO is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of oncology. In order to promote productive academic communication, the peer review process for the WJCO is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCO are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in oncology. Scope: Art of Oncology, Biology of Neoplasia, Breast Cancer, Cancer Prevention and Control, Cancer-Related Complications, Diagnosis in Oncology, Gastrointestinal Cancer, Genetic Testing For Cancer, Gynecologic Cancer, Head and Neck Cancer, Hematologic Malignancy, Lung Cancer, Melanoma, Molecular Oncology, Neurooncology, Palliative and Supportive Care, Pediatric Oncology, Surgical Oncology, Translational Oncology, and Urologic Oncology.