Subscribe to RSS
DOI: 10.1055/a-1893-5910
Endoscopic submucosal dissection for superficial nasopharyngeal carcinoma
Early-stage nasopharyngeal cancer is treated by radiotherapy or chemoradiotherapy [1]. Radiotherapy is less toxic than chemoradiotherapy but has a reported failure rate of 15–30 %. Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for superficial oropharyngeal and hypopharyngeal cancers [2] [3] [4], but it has not been previously performed for nasopharyngeal cancer owing to the difficulty of an endoscopic approach. This case report demonstrates ESD for nasopharyngeal lesions.
A 42-year-old man complained of throat discomfort, and papillary tumors were detected in the nasopharynx and oropharynx by nasopharyngolaryngoscopy. Biopsy specimens obtained from these lesions showed squamous cell papilloma with severe atypia. ESD was planned for total biopsy of these lesions.
The patient was transorally intubated and ESD was performed under general anesthesia. A mouth opener was placed and the uvula was pulled with a thread to secure the field of view ([Fig. 1]). An endoscope with an 8.9-mm diameter tip (GIF-H290; Olympus Corporation, Tokyo, Japan), which cannot be inserted transnasally under sedation, was used. The nasopharyngeal lesions were approached using this scope in the transnasal forward and transoral retroflex views ([Fig. 2]). En bloc resection was achieved by ESD for all four lesions using an electrosurgical knife (Flushknife 1.5 mm; FUJIFILM Medical Co., Ltd., Tokyo, Japan) ([Video 1]). He was discharged on postoperative day 4 without any adverse events.
Video 1 Endoscopic submucosal dissection for nasopharyngeal lesions with transnasal and transoral approaches.
Quality:
Histologic examinations showed an intraepithelial squamous cell carcinoma for lesion #1 of the posterior wall of the nasopharynx and papilloma for the others (lesions #2 and #3). Follow-up endoscopy 4 months after ESD showed no remnant lesion or stenosis ([Fig. 3]).
Endoscopy_UCTN_Code_CPL_1AH_2AZ
Endoscopy E-Videos is an open access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online. Processing charges apply (currently EUR 375), discounts and wavers acc. to HINARI are available.
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos
Publication History
Article published online:
01 September 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Cheng SH, Tsai SY, Yen KL. et al. Concomitant radiotherapy and chemotherapy for early-stage nasopharyngeal carcinoma. J Clin Oncol 2000; 18: 2040-2045
- 2 Iizuka T, Kikuchi D, Hoteya S. et al. Endoscopic submucosal dissection for treatment of mesopharyngeal and hypopharyngeal carcinomas. Endoscopy 2009; 41: 113-117
- 3 Hanaoka N, Ishihara R, Takeuchi Y. et al. Endoscopic submucosal dissection as minimally invasive treatment for superficial pharyngeal cancer: a phase II study (with video). Gastrointest Endosc 2015; 82: 1002-1008
- 4 Kinjo Y, Nonaka S, Oda I. et al. The short-term and long-term outcomes of the endoscopic resection for the superficial pharyngeal squamous cell carcinoma. Endosc Int Open 2015; 3: E266-E273