title: En bloc resection of a large semicircular esophageal cancer by endoscopic submucosal dissection.
abstract: A semicircular esophageal cancer, approximately 7 cm wide, was detected in the middle to lower esophagus of an 81-year-old gentleman during an esophagogastroduodenoscopy. Thorough examinations using chromoendoscopy and endoscopic ultrasonography led to preoperative diagnosis of an intramucosal tumor. With informed consent, the patient underwent endoscopic submucosal dissection (ESD), a novel endoscopic treatment. A successful en bloc resection by ESD was completed without complications. The resected specimen measured 72 mm by 35 mm, and the cancer was contained in an area of 66 mm by 32 mm. Histologic assessment revealed squamous cell carcinoma, microinvasive into the mucosal layer, but without vessel infiltration. Six months after ESD, mild stenosis remained, but dilation was no longer needed, and esophagogastroduodenoscopy with chromoendoscopy and biopsy revealed no residual or recurrent cancer.
authors.affiliation: Department of Gastroenterology, Graduate school of Medicine, University of Tokyo, Tokyo. mtfujish-kkr@umin.ac.jp
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yahagi
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.forename: Shinya
authors.initials: S
authors.lastname: Kodashima
authors.forename: Masao
authors.initials: M
authors.lastname: Ichinose
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000369:Aged, 80 and over; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000295:instrumentation / Q000379:methods*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus; D006801:Humans; D008297:Male; D009092:Mucous Membrane