Type 0-I superficial esophageal cancer in which the course of development was observed, report of two cases
Yamada, K.; Yoshida, M.; Momma, K.; Hanashi, T.; Sakai, N.
Stomach and Intestine 30(11): 1391-1396
ISSN/ISBN: 0536-2180 Accession: 009687393
(Case 1) A 48-year-old male was admitted to our hospital because of esophageal abnormalities. Three years ago during conventional endoscopy white and finely granular changes at the distal esophageal mucosa were noticed and suspected to be esophagitis. Recent endoscopy revealed a superficial and protruded esophageal lesion which was diagnosed as submucosal cancer (type 0-I). A radical esophagectomy was carried out. Pathological studies on resected specimens revealed a squamous cell carcinoma infiltrating massively into the submucosa (sm-3) without lymph node metastasis. The patient is alive without any sign of recurrence after five years and four months following the surgery. (Case 2) A 63-year-old male was admitted to our hospital because of esophageal tumor. He had already undergone an endoscopy and a small, white and elevated lesion was noticed in the middle third of the esophagus. Pathological studies on bite biopsy specimens revealed a papilloma. A repeated endoscopy revealed that the esophageal tumor had increased in size, which was suggestive of superficial and protruding-type esophageal cancer (type 0-I). A bite biopsy revealed a squamous cell carcinoma. The patient strongly wanted endoscopic mucosal resection as treatment. Pathological studies on the resected specimen revealed a squamous cell carcinoma reaching to the muscularis mucosae (m3). He received irradiation to the posterior mediastinum for probable lymph node metastasis. He is alive without any sign of recurrence after four years and four months. These results suggested that there are two different type 0-I esophageal cancers. One was a solid tumor with protrusion, reddening and invasion into the deeper third of the submucosa. Another was a protruded lesion with white colour and granular changes. It infiltrated the muscularis mucosae but not the submucosa. In cases with type 0-I lesions, these gross findings should be considered for precise estimation of the depth of invasion.