A case of superficial esophageal squamous cell carcinoma showing acute growth of mediastinal lymph nodal metastasis after endoscopic submucosal dissection

Endoscopic submucosal dissection (ESD) is becoming a common and useful treatment for superficial esophageal cancer, especially for tumors confined to the lamina propria mucosae which can be completely resected without any cancers fraction left. Here we report a case in which an SM infiltrated esophageal cancer resected by ESD, revealed a rapid and aggressive metastasis to a mediastinal lymph node (n106recR) before additional curative surgery. The possible existence of the lymph node metastasis could not be denied by retrospective reassessment of CT which was performed before ESD. Although a relationship between the aggressive lymph node metastasis and the ESD procedure is unclear in this case, careful preoperative evaluation is necessary for the expansion of the indication of ESD for esophageal cancers.