Esophageal squamous cell carcinoma with entirely intramural growth pattern

Esophageal cancers are predominantly carcinomas, which are—due to their origin from the epithelial lining—visible by endoluminal view. We report in this study about the rare case of an esophageal squamous cell cancer with an unusual, entirely intramural growth pattern. The diagnosis could only be established postoperatively, because all preoperative biopsies had failed to demonstrate the tumor. The entirely intramural growth pattern of esophageal squamous cell cancer is an exceedingly rare variant, with only one previously reported case. Nevertheless, clinicians, radiologists, and pathologists should be aware of the potential existence of this condition, especially when clinical and imaging results suggest a malignant tumor that cannot be proven on biopsies. Surgical exploration must be considered under these circumstances.