Endoscopic Submucosal Dissection for Synchronous Early Hypopharyngeal and Esophageal Squamous Cell Carcinoma: a Case Report with 24-Month Follow-Up

Introduction and importance:Hypopharyngeal carcinoma (HC) is a relatively rare malignancy, with an incidence of approximately 0.7 per 100 000 individuals. The early detection rate of hypopharyngeal carcinoma is low, ranging from 4% to 13%. Synchronous early detection of esophageal cancer (EC) and hypopharyngeal carcinoma occurs in approximately 15% of cases. Gastrointestinal endoscopy with image-enhanced endoscopy (IEE) using narrow-band imaging (NBI) is a valuable tool for synchronous early detection of hypopharyngeal carcinoma. Endoscopic submucosal dissection (ESD) is a minimally invasive, safe, and effective method for endoscopic resection. Presentation of case:We reported the case of a 46-year-old Vietnamese male diagnosed with synchronous early-stage left pyriform sinus cancer and EC diagnosed using gastrointestinal endoscopy with image-enhanced endoscopy with narrow-band imaging (IEE-NBI). Both lesions were successfully resected en bloc using ESD. After 24 months of follow-up, there were no new lesions or metastases from the tumor. Clinical discussion:This case highlights the application of NBI classification according to intrapapillary capillary loops morphology under IEE-NBI endoscopy for the diagnosis of synchronous early HC and EC and the prediction of the invasion depth based on microvessel morphology. Conclusion:Gastroenterologists should be vigilant in observing the pharynx with IEE-NBI for patients with EC to facilitate early detection of HC, and vice versa.