Early-stage laryngeal squamous cell carcinoma of the epiglottis treated by endoscopic submucosal dissection.

copists have enabled detection of laryn− geal and pharyngeal cancer at an early stage, especially in Japan [1 ±3]. In addi− tion, endoscopic mucosal resection (EMR) and endoscopic submucosal dis− section (ESD) [4] have recently been used for treatment of hypopharyngeal cancer at an early stage. In this report, we de− scribe for the first time a case of early− stage laryngeal carcinoma that was suc− cessfully treated by ESD. A 61−year−old man was admitted to Hok− kaido University Hospital because of a laryngeal cancer, which was found by fol− low−up endoscopy after EMR of esopha− geal cancer. The patient had a history of heavy smoking and alcohol consumption. On endoscopic examination, a round, flat± elevated lesion measuring 1.5 ” 1.0 cm was noted on the front right part of the epiglottis (l" Fig. 1). The surface was red− dish and granular without any ulcera− tions. A whole−body CT scan demonstrat− ed no lymphadenopathy. ESD was per− formed with the patient under general anesthesia. Submucosal dissection was done with a needle knife, and was per− formed successfully without complica− tions (l" Fig. 2 a). Histopathologic exami− nation of the resected specimen showed that squamous cell carcinoma had very slightly invaded the subepithelial layer (l" Fig. 2 b, c). The margins of the resected specimen were free histologically. There was no invasion into veins or lymph ves− sels. There has been no recurrence during a follow−up period of 9 months after ESD. In this case, by using the ESD technique, an en−bloc resected specimen and accu− rate histological evaluation were ob− tained without the occurrence of any complication such as injury to the epi− glottis. Gastrointestinal endoscopy can now provide images of higher quality than those obtained by laryngoscopy. Gastrointestinal endoscopists should strive to find supraglottic cancer at an early stage in the laryngeal area for pa− tients in the high−risk group such as hea− vy drinkers and heavy smokers [3], and of course it is necessary to cooperate with the otolaryngologist to treat. Endoscopy_UCTN_Code_TTT_1AO_2AG Endoscopy_UCTN_Code_TTT_1AO_2AD Early−stage laryngeal squamous cell carcinoma of the epiglottis treated by endoscopic submucosal dissection