Esophageal superficial adenosquamous carcinoma resected by endoscopic submucosal dissection:A rare case report

BACKGROUND Adenosquamous carcinoma(ASC),which is comprised of squamous cell carcinoma(SCC)and adenocarcinoma elements,is a rare histological type of esophageal carcinoma.Few reports have focused on the endoscopic findings and the effectiveness of the endoscopic treatment of early ASC.CASE SUMMARY A 77-year-old man underwent esophagogastroduodenoscopy for heartburn.A flat lesion with an uneven and slightly elevated central portion was found in the distal esophagus.Magnifying endoscopy with narrow-band imaging showed a well-demarcated brownish area with dendritically branched abnormal vessels and highly irregular intrapapillary capillary loops.A histopathological diagnosis of SCC was obtained by endoscopic biopsy.Endoscopic ultrasonography revealed a hypoechoic mass confined to the mucosa layer.The lesion was suspected to be SCC with invasion into the muscularis mucosa.The lesion was resected en bloc by endoscopic submucosal dissection and histologically diagnosed as esophageal ASC limited within the muscularis mucosa,which was completely resected without lymphovascular or neural invasion.The SCC element was the predominant element.The adenocarcinoma element formed ductal and nested structures distributed in a focal pattern.The patient underwent only endoscopic submucosal dissection and has been under annual endoscopic and radiographic surveillance for 3 years without recurrence.CONCLUSION For early ASC confined within the mucosal layer,complete endoscopic resection might also be a curative treatment.

Rare squamous cell carcinoma of the jejunum causing perforated peritonitis: A case report

BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine(SI).Squamous cell carcinoma(SCC)often occurs in organs covered with squamous epithelium.Primary or metastatic SCC originating from the SI is very rare,with very few cases reported in the literature.CASE SUMMARY This case report involves a 69-year-old man who developed abdominal pain after lunch.After admission,an abdominal computed tomography scan revealed perforation of the alimentary canal and multiple abnormal low-density lesions in the liver.During laparotomy,an approximately 4 cm×3 cm-sized solid tumor was found in the jejunum,located 30 cm from the Treitz ligament,with a perforation.An intestinal segment of approximately 15 cm was removed,including the perforated portion.The pathological result was SCC.In combination with liver imaging,a diagnosis of SI SCC with multiple liver metastases was considered.The patient died from hepatic failure 1 mo after the operation.CONCLUSION SI tumors are very rare compared to those originating in other digestive organs.Due to its insidious onset,the diagnosis of this disease is usually delayed.Clinicians must pay close attention to digestive symptoms such as persistent abdominal pain and melena.