Mou Y, Li S, Zhang YH, Hu B. Endoscopic submucosal dissection combined with radiotherapy for T1b esophageal lymphoepithelioma-like carcinoma: A case report. World J Gastrointest Endosc 2026; 18(10): 122913 [DOI: 10.4253/wjge.122913]
Corresponding Author of This Article
Yi Mou, MD, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. 125654639@qq.com
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case-report
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Mou Y, Li S, Zhang YH, Hu B. Endoscopic submucosal dissection combined with radiotherapy for T1b esophageal lymphoepithelioma-like carcinoma: A case report. World J Gastrointest Endosc 2026; 18(10): 122913 [DOI: 10.4253/wjge.122913]
World J Gastrointest Endosc. Oct 16, 2026; 18(10): 122913 Published online Oct 16, 2026. doi: 10.4253/wjge.122913
Endoscopic submucosal dissection combined with radiotherapy for T1b esophageal lymphoepithelioma-like carcinoma: A case report
Yi Mou, Shan Li, Yu-Hang Zhang, Bing Hu
Yi Mou, Shan Li, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yu-Hang Zhang, Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Bing Hu, Department of Gastroenterology and Hepatology, Medical Engineering Integration Laboratory of Digestive Endoscopy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Li S drafted the manuscript and prepared the video clip; Zhang YH collected the data and revised the manuscript; and Mou Y and Hu B conceptualized the study, performed the endoscopic examination, and critically revised the manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by National Natural Science Foundation of China, No. 82170675.
Informed consent statement: Informed consent was obtained from the patient to publish these images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
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).
Corresponding author: Yi Mou, MD, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. 125654639@qq.com
Received: May 8, 2026 Revised: July 22, 2026 Accepted: August 31, 2026 Published online: October 16, 2026 Processing time: 160 Days and 13.5 Hours
Abstract
BACKGROUND
Esophageal lymphoepithelioma-like carcinoma is a rare, poorly differentiated neoplasm lacking standardized endoscopic treatment. It is prone to misdiagnosis as a subepithelial lesion, with false-negative biopsy results. Tiny superficial lesions may still exhibit submucosal invasion. Reports on endoscopic submucosal dissection for this disease are limited, and the necessity of adjuvant radiotherapy remains controversial in the absence of unified clinical guidelines.
CASE SUMMARY
A 59-year-old man with a history of total gastrectomy had a 1.0-cm superficial esophageal lesion. Endoscopic evaluation suggested submucosal invasion, while computed tomography imaging ruled out metastatic disease. En bloc endoscopic submucosal dissection was subsequently performed. Pathological examination confirmed T1b-SM2 lymphoepithelioma-like carcinoma with negative margins and no evidence of Epstein–Barr virus infection. The patient received adjuvant radiotherapy at a dose of 6000 cGy. Regular follow-up with endoscopy and thoracic computed tomography has shown no signs of local or distant recurrence.
CONCLUSION
Minute esophageal lymphoepithelioma-like carcinoma may harbor a risk of deep invasion. Radiotherapy may be considered as subsequent therapy, though further evidence is needed.
Core Tip: Esophageal lymphoepithelioma-like carcinoma is a rare entity prone to misdiagnosis. We report a case of tiny T1b esophageal lymphoepithelioma-like carcinoma treated with en bloc endoscopic submucosal dissection followed by adjuvant radiotherapy. Despite the small lesion size, submucosal invasion was present. No recurrence was observed during 3 years of follow-up. This case suggests that even small superficial lymphoepithelioma-like carcinoma may harbor invasive potential. Although adjuvant radiotherapy was administered in accordance with esophageal cancer guidelines, a unified treatment consensus for this rare pathology remains lacking and requires further investigation.
