Endoscopic submucosal dissection for an atypical small verrucous carcinoma: a case report.

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Endoscopic submucosal dissection for an atypical small verrucous carcinoma: a case report.

J Med Case Rep. 2016 Mar 25;10:74

Authors: Abe T, Kato M, Itagaki M, Hamatani S, Kawahara Y, Ito S, Aizawa Y, Matsuda K, Sumiyama K

Abstract
BACKGROUND: Esophageal verrucous carcinoma is a rare variant of esophageal squamous cell carcinoma. In most cases, verrucous carcinoma presents as an exophytic, slow-growing mass with an extensive superficial growth pattern. Symptoms often include an insidious onset of dysphagia resulting in weight loss. In a patient presenting with super early-stage verrucous carcinoma, we were able to eliminate the aberration using endoscopic submucosal dissection.
CASE PRESENTATION: An asymptomatic 68-year-old Asian man was found to have an abnormality in his esophagus. The abnormality was discovered, by chance, in a barium study for a health checkup. Esophagogastroduodenoscopy revealed a 1-centimeter polypoid lesion covered with squamous epithelium. Biopsies showed squamous high-grade intraepithelial neoplasia. An endoscopic submucosal dissection was performed and the histopathological findings showed a well-differentiated squamous cell carcinoma with hyperkeratosis with a church spire configuration. These features are consistent with the growth pattern of verrucous carcinoma.
CONCLUSIONS: Verrucous carcinoma can manifest as a small mass with nonclinical symptoms and endoscopic submucosal dissection is useful as a curative treatment. We must consider that verrucous carcinoma can manifest as appearance of a polyp that is not papillary or warty-like with and without extensive superficial growth appearance.

PMID: 27036299 [PubMed - indexed for MEDLINE]

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