White Opaque Substance In Superficial Esophageal Squamous Cell Carcinoma: Report Of A Case

White opaque substance (WOS) observed in the gastric neoplasia by magnifying endoscopy with narrow band imaging (NBI-ME) has been reported to be useful for differentiation of gastric cancerous and non-cancerous lesions. Using oil red O staining and adipophilin immunostaining reveals WOS in gastric neoplasms as lipid droplets, and WOS is specific for neoplasm with intestinal or gastrointestinal phenotype. We here in report a case of superficial esophageal squamous cell carcinoma with WOS. A male patient in his seventies was found by esophagogastro-duodenoscopy to have two superficial esophageal lesions and two superficial gastric lesions. NBI-ME observed WOS in both gastric lesions and in one esophageal lesion. The patient underwent endoscopic submucosal dissection and all the lesions were resected en bloc successfully. All four lesions had diffuse positivity for adipophilin on immunostaining. This is the first case reported that WOS was observed in esophageal squamous cell carcinoma.