Chen D, Zhong DF, Liu D. Exploration of preventive treatment for high risk patients with metachronous multiple esophageal squamous cell carcinoma: A case report. World J Clin Oncol 2025; 16(8): 108371 [DOI: 10.5306/wjco.v16.i8.108371]
Corresponding Author of This Article
Dong Liu, Associate Chief Physician, Department of Hepatobiliary and Pancreatic Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, No. 267 Danxi East Road, Jindong District, Jinhua 321000, Zhejiang Province, China. li375dong@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Clin Oncol. Aug 24, 2025; 16(8): 108371 Published online Aug 24, 2025. doi: 10.5306/wjco.v16.i8.108371
Exploration of preventive treatment for high risk patients with metachronous multiple esophageal squamous cell carcinoma: A case report
Dan Chen, Ding-Fu Zhong, Dong Liu
Dan Chen, Ding-Fu Zhong, Department of Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, Jinhua 321000, Zhejiang Province, China
Dong Liu, Department of Hepatobiliary and Pancreatic Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, Jinhua 321000, Zhejiang Province, China
Author contributions: Chen D, Zhong DF, and Liu D collected and analyzed the data; Chen D and Liu D drafted the manuscript; Liu D critically revised paper; and all authors have read and approved the final version to be published.
Supported by Jinhua City Science and Technology Plan Projects, No. 2022-4-145.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest related to this article.
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).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Liu, Associate Chief Physician, Department of Hepatobiliary and Pancreatic Gastroenterology, Affiliated Jinhua Hospital of Wenzhou Medical University, Jinhua People’s Hospital, No. 267 Danxi East Road, Jindong District, Jinhua 321000, Zhejiang Province, China. li375dong@163.com
Received: April 23, 2025 Revised: June 14, 2025 Accepted: July 17, 2025 Published online: August 24, 2025 Processing time: 119 Days and 20.4 Hours
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.
Core Tip: The grade of Lugol-voiding lesions is associated with risk of metachronous squamous cell carcinomas (SCCs). Effective methods to prevent metachronous multiple SCCs are needed in survivors of esophageal squamous cell carcinomas. We present the first case of multiple dysplastic lesions of esophagus cured by radiotherapy. This case indicated that radiotherapy after endoscopic submucosal dissection might be a safe and effective optional therapeutic strategy to prevent metachronous multiple esophageal SCCs.
