Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2017; 23(45): 8097-8103
Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8097
Endoscopic submucosal dissection in a patient with esophageal adenoid cystic carcinoma
Kenichi Yoshikawa, Akiyoshi Kinoshita, Yuki Hirose, Keiko Shibata, Takafumi Akasu, Noriko Hagiwara, Takeharu Yokota, Nami Imai, Akira Iwaku, Go Kobayashi, Hirohiko Kobayashi, Nao Fushiya, Hiroyuki Kijima, Kazuhiko Koike, Haruka Kaneyama, Keiichi Ikeda, Masayuki Saruta
Kenichi Yoshikawa, Akiyoshi Kinoshita, Yuki Hirose, Keiko Shibata, Takafumi Akasu, Noriko Hagiwara, Takeharu Yokota, Nami Imai, Akira Iwaku, Go Kobayashi, Hirohiko Kobayashi, Nao Fushiya, Hiroyuki Kijima, Kazuhiko Koike, Division of Gastroenterology and Hepatology, Internal Medicine, Jikei University Daisan Hospital, Tokyo 201-8601, Japan
Haruka Kaneyama, Keiichi Ikeda, Department of Endoscopy, Jikei University Daisan Hospital, Tokyo 201-8601, Japan
Masayuki Saruta, Division of Gastroenterology and Hepatology, Internal Medicine, Jikei University School of Medicine, Tokyo 105-8471, Japan
Author contributions: All authors contributed equally to this work; Yoshikawa K and Kanayama H provided the treatment; Yoshikawa K analyzed the data and wrote the manuscript’s text; Kinoshita A wrote the supplementary information; all of the authors discussed the results and commented on the manuscript at all stages.
Informed consent statement: We received patient consent with regard to this manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kenichi Yoshikawa, MD, PhD, Doctor, Staff Physician, Division of Gastroenterology and Hepatology, Internal Medicine, Jikei University Daisan Hospital, 4-11-1 Izumihon-cho, Komae-shi, Tokyo 201-8601, Japan. kyoshikawa@jikei.ac.jp
Telephone: +81-3-34801151 Fax: +81-3-34303611
Received: September 14, 2017
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
Abstract

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.

Keywords: Adenoid cystic carcinoma of esophagus, Endoscope, Ultrasound, Esophageal, Tumor, Endoscopic submucosal dissection

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.