Multimodality treatments for nodal relapse after endoscopic mucosal resection of a superficial esophageal squamous cell carcinoma

Patients with esophageal intraepithelial carcinoma (m1) and carcinoma invading the lamina propria (m2) are generally considered good candidates for endoscopic mucosal resection (EMR) in Japan, as hardly any of them show lymph node metastasis. Although a few cases of esophageal carcinoma invading the lamina propria have been reported to show nodal involvement, lymph node metastasis and subsequent death due to carcinoma after EMR of m1 or m2 esophageal carcinoma has never been reported in the English literature. Here we describe a patient who suffered relapse of lymph node metastasis after EMR of an esophageal carcinoma invading the lamina propria without any of the reported risk factors associated with lymph node metastasis, including vascular invasion. Unfortunately, the patient died due to disease recurrence, despite receiving multimodality treatments including chemoradiotherapy and salvage surgery.

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