A Case Report of Superficially Spreading Early Esophageal Cancer Detected after Endoscopic Removal of a Foreign Body.

A 64-year-old male was admitted to our hospital because a piece of meat had become stuck in his esophago-cardiac junction (ECJ). We removed the piece of meat in the ECJ using endoscopy. A subsequent endoscopy revealed a superficially-spreading early esophageal carcinoma in the lower part of the esophagus and an esophagitis-like lesion in the intrathoracic middle esophagus. Right thoracotomy and esophagectomy were carried out. The two chief lesions were a superficially-spreading early esophageal carcinoma in the lower esophagus, and a similar tumor occupying an area extending from the upper to the middle esophagus. Histopathologically, the squamous cell carcinoma of the lower esophagus was of the total layer type, but the tumor in the middle esophagus was of the basal layer type. The histological difference in the tumor proliferation between the two lesions may be associated with the exfoliation of the intraepithelial carcinoma in the former case, and natural proliferation in the latter. The exfoliation of the intraepithelial carcinoma was thought to have been induced by the endoscopic removal of the meat lump. Furthermore, six solitary neoplastic lesions were noted independently. Histological findings in the present case support the concept of a“field carcinogenesis”and/or“lateral involvement”of esophageal carcinoma.