Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2019; 7(5): 668-675
Published online Mar 6, 2019. doi: 10.12998/wjcc.v7.i5.668
Use of tunnel endoscopy for diagnosis of obscure submucosal esophageal adenocarcinoma: A case report and review of the literature with emphasis on causes of esophageal stenosis
Song Liu, Nian Wang, Jian Yang, Jia-Yao Yang, Zhao-Hong Shi
Song Liu, Nian Wang, Jian Yang, Jia-Yao Yang, Zhao-Hong Shi, Department of Gastroenterology, The First Hospital of Wuhan, Wuhan 430000, Hubei Province, China
Author contributions: Liu S and Wang N contributed to study conception and design, data collection, assembly, and analysis, manuscript writing, and literature search, and they contributed equally to this work; Yang J contributed to the collection and assembly of data; Yang JY contributed to data analysis and study conception; Shi ZH contributed to valuable suggestions; all authors reviewed and approved the manuscript.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The manuscript was revised according to the CARE Checklist guidelines.
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:
Corresponding author: Zhao-Hong Shi, PhD, Chief Doctor, Department of Gastroenterology, The First Hospital of Wuhan, No. 215, Zhongshan Road, Qiaokou District, Wuhan 430000, Hubei Province, China.
Telephone: +86-27-85332309
Received: November 12, 2018
Peer-review started: November 12, 2018
First decision: December 20, 2018
Revised: January 13, 2019
Accepted: January 30, 2019
Article in press: January 29, 2019
Published online: March 6, 2019

The tunnel endoscopic technique is the treatment of choice for submucosal tumors. However, the use of tunnel endoscopy to diagnose adenocarcinoma of the esophagus originating from the submucosa has not been well studied.


A 74-year-old man who presented with dysphagia for half a year underwent a series of checks, such as gastroendoscopy, X-ray contrast examination of the upper digestive tract, endoscopic ultrasonography, high-resolution esophageal manometry, and positron emission computed tomography. It should be noted that the stenosis of the esophagus was too narrow for endoscopic ultrasound-guided fine needle aspiration. The cause remained undiagnosed. Eventually, the tunnel endoscopic technique was perform for the pathological examination in the submucosa and the final diagnosis was adenocarcinoma of the esophagus. The patient and family members chose expectant treatment due to the patient’s age and the high costs of surgical treatment.


Tunnel endoscopy could be used to diagnose tumors. Moreover, we review the literature to provide guidance regarding the causes of esophagostenosis.

Keywords: Esophageal stenosis, Adenocarcinoma of the esophagus, Tunnel endoscopic technique, Case report

Core tip: Tunnel endoscopy is not only effective as a treatment for submucosal tumors, but also as a means of performing pathological examination for diagnosing tumors. Moreover, we review the literature to provide guidance regarding the causes of esophageal stenosis.