Early esophageal cancer with mucosal bridging in the resting room: A case report

Abstract

BACKGROUND

Patients diagnosed with esophageal mucosal bridges often experience symptoms such as chest pain and dysphagia, which pose considerable challenges for endoscopic surgical interventions.

CASE SUMMARY

We present a case involving early-stage esophageal cancer discovered in a resting room, notable for the rare manifestation of esophageal mucosal bridging. Following a comprehensive multidisciplinary discussion and the development of a treatment strategy, we proceeded with endoscopic submucosal dissection for the patient. During the procedure, we encountered operational challenges due to the presence of a diverticulum and a partial absence of the muscularis propria. To facilitate the retraction of a portion of the resected specimen, we utilized dental floss. Ultimately, we successfully excised the entire lesion. After a three-day period of fasting with a water-only diet, subsequent iodine water cholangiography did not indicate any perforations, and the patient was advised to transition to a liquid diet. The patient was discharged five days post-operation. A follow-up endoscopy conducted three months later revealed scar-like changes in the mid-esophagus, with the patient reporting no significant discomfort.

CONCLUSION

In summary, although esophageal mucosal bridges are rarely documented, they should be considered in the differential diagnosis of mechanical dysphagia. Furthermore, endoscopic therapy represents a feasible approach for their management.

Keywords: Esophageal cancer; Endoscopic submucosal dissection; Esophageal mucosal bridging; Esophagus; Case report

Core Tip: Currently, there exists a paucity of documented cases of submucosal bridges in the esophagus, and no instances have been reported linking submucosal bridges to carcinogenesis within diverticula. In the case under discussion, the tubular structure of the submucosal bridge, along with the detailed pathological features indicative of carcinogenesis, was clarified through the application of thin sectioning of the surgical specimen obtained after endoscopic submucosal dissection.