Download PDF
Open Access
CC BY 4.0 · Endoscopy 2025; 57(S 01): E1310-E1311
DOI: 10.1055/a-2725-7222
E-Videos

A case presentation of a metachronous superficial epiglottic lesion excised by endoscopic submucosal dissection

Authors

  • Chenchen Zhang

    1   Department of Gastrointestinal Endoscopy Center, The Second Qilu Hospital, The Second Clinical Medical School of Shandong University, Jinan, China (Ringgold ID: RIN66555)

  • Zhaosheng Chen

    1   Department of Gastrointestinal Endoscopy Center, The Second Qilu Hospital, The Second Clinical Medical School of Shandong University, Jinan, China (Ringgold ID: RIN66555)

  • Nan Zhang

    1   Department of Gastrointestinal Endoscopy Center, The Second Qilu Hospital, The Second Clinical Medical School of Shandong University, Jinan, China (Ringgold ID: RIN66555)

  • Daoyu Tao

    2   Department of Pathology, The Second Qilu Hospital, The Second Clinical Medical School of Shandong University, Jinan, China (Ringgold ID: RIN66555)

  • Honglei Wu

    1   Department of Gastrointestinal Endoscopy Center, The Second Qilu Hospital, The Second Clinical Medical School of Shandong University, Jinan, China (Ringgold ID: RIN66555)
Further Information
Also available at
  Permissions and Reprints

A case presentation of a metachronous superficial epiglottic lesion excised by endoscopic submucosal dissection.

Previous reports [1] [2] have shown that patients with esophageal squamous cell carcinoma (ESCC) have an increased risk of synchronous and metachronous squamous cell carcinoma of the head and neck. The piriform sinus and posterior pharyngeal wall are the most common sites for the development of metachronous lesions. Systematic endoscopic pharyngeal evaluation is vital for the surveillance of the regions [3]. Here, we present a metachronous superficial lesion in the vallecula epiglottica – a rare site – which occurred after superficial ESCC.

A 69-year-old man underwent endoscopic submucosal dissection (ESD) for circumferential superficial cancer in the upper thoracic esophagus 1.5 years ago. He was diagnosed with a superficial neoplastic lesion in the vallecula epiglottica during a follow-up gastroscopy recently. A 1.0-cm, slightly reddish with whitish plaques, flat (0–IIb), well-demarcated lesion was detected under white light ([Fig. 1] a), demonstrating pale brown under narrowband imaging (NBI) ([Fig. 1] b). Under magnifying endoscopy with NBI, type B1 vessels were detected in the reddish area, and the vessels were vague in the whitish area ([Fig. 1] c, d). Biopsy results revealed carcinoma in situ, and a computed tomography scan revealed no metastasis. Under tracheal intubation anesthesia, the lesion was removed by ESD using a GOLDKNIFE (Micro-tech, Nanjing, China), and no adverse events occurred ([Video 1]). The lesion was marked under NBI with ME distinctly, following a circumferential mucosal incision and submucosal dissection. En bloc resection of the lesion was performed in this anatomically challenging region. Histopathology confirmed carcinoma in situ with negative margins ([Fig. 2]).

Zoom
Fig. 1 Endoscopic features of the lesion. a White light view: slightly reddish with whitish plaques, Paris 0-IIb, well-demarcated; b pale brown under narrowband imaging (NBI); and c, d magnifying endoscopy findings with NBI: type B1 vessels (JES) were detected in the reddish area, while the vessels appeared vague in the whitish area.
Gastroscopy showing endoscopic features of the lesion and the procedure of endoscopic submucosal dissection (ESD).Video 1

Zoom
Fig. 2 Histopathological findings of the endoscopically dissected specimen. a, b HE staining (10×); the tumor shows strong positivity for (c) Ki67 and (d) P53.

In conclusion, we present the rare case of early pharyngeal cancer in the epiglottic vallecula. Considering that ESD has been a feasible and effective treatment for early pharyngeal lesions, detailed endoscopic pharyngeal evaluation is vital for early detection, especially in patients with an ESCC history.

Endoscopy_UCTN_Code_CCL_1AB_2AB

Endoscopy E-Videos https://eref.thieme.de/e-videos

E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).

This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.



Publication History

Article published online:
19 November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany