A 60-year-old male patient, who diagnosed with laryngopharyngeal squamous cancer (pT4N2M0) treated with laryngopharyngectomy and postoperative chemoradiotherapy three years ago, received an endoscopy in routine follow-up. One superficial elevated lesion adjacent surgical scar was discovered around posterior pharyngeal wall (Fig. 1). Histopathology indicated severe dysplasia of squamous epithelium. CT and MRI imaging with contrast showed no obvious lesions. He was diagnosed with asynchronous pharyngeal carcinoma and received endoscopic treatment after MDT discussion. The lesion was removed en bloc via endoscopic submucosal dissection (ESD) (sFig.1). Pathology reported the lesion with 20.0*19.0 mm in diameter, confined to mucosa, without lymphovascular or neural invasion (Fig. 2). He recovered well without recurrence or metastasis in two-year follow-up. Generally, patients with asynchronous hypopharyngeal carcinoma who undergone radical chemoradiotherapy are recommended for conservative treatment or reoperation [1]. We reported ESD might be an effective treatment, and the clip-line traction and EndoCut I mode setting were vital for high-performance ESD.
Fig. 1
Representative endoscopic images of the hypopharyngeal lesion. A The patient received laryngopharyngectomy and a permanent tracheotomy three years ago. B One superficial elevated lesion (type 0–IIa, about 2.0 cm in diameter) was detected on the right posterior hypopharyngeal wall. The lesion was smooth and slightly reddish, with clear demarcation line under white light image endoscopy. Brownish dots and abnormal intraepithelial capillary loops were identified on the surface under narrow-band imaging endoscopy. C Macroscopic image after en bloc resection. The well-demarcated Lugol-voiding area was visualized after spraying Lugol iodine solution
Fig. 2
The histopathology of the hypopharyngeal lesion. The pathologic examination revealed a flat tumor (20.0*19.0 mm in diameter) arising from the mucosa. The histopathologic structure was swell-differentiated squamous cell carcinoma, and both lateral and vertical resection margins were negative
Obesity is a major contributor to cardiorenal metabolic disease, but its impact extends throughout the body. Understand how obesity can affect other organ systems and impact treatment, and whether weight-loss measures improve outcomes.
Elevate your patient care with our comprehensive, evidence-based medical education on women's health. Designed to help you provide exceptional care for your female patients at every stage of life, we provide expert insights into topics such as reproductive health, menopause, breast cancer and sex-specific health risks and precision medicine.
Systemic lupus erythematosus is a severe autoimmune disease that can cause damage to almost every system of the body. Join this session to learn more about novel biomarkers for diagnosis and monitoring and familiarise yourself with current and emerging targeted therapies.
Join us live: Tuesday 27th May, 18:00-19:15 (CEST)
