Rare case of early squamous cell carcinoma extending from the cardia to the fundus cured by endoscopic submucosal dissection

A 70-year-old asymptomatic man with a preference for hot food and chronic alcohol consumption presented to our hospital for screening esophagogastroduodenoscopy, which revealed squamous metaplasia extending from the cardia to the fundus of the stomach ([Fig. 1]). Narrow-band imaging and magnified endoscopy showed a brown area and abnormal intraepithelial papillary capillary loops of type B1 within the squamous metaplasia of the stomach mucosa ([Fig. 2]), suggestive of early squamous cell carcinoma (SCC) with a low risk of submucosal infiltration. Biopsy confirmed high-grade dysplasia of the squamous epithelium. Endoscopic submucosal dissection (ESD) was performed to resect the lesion ([Video 1]). Lugol's iodine staining was used to determine the margin of the neoplasm before ESD, revealing a clear unstained area within a large area of dark brown mucosa ([Fig. 3]). Some columnar epithelial islands remained within the squamous metaplasia of the mucosa, with some unstained areas located outside the lesion. The lesion was completely resected without complications ([Fig. 4]). Histopathology confirmed an intramucosal SCC infiltrating into the lamina propria (pT1a-M2) ([Fig. 5]).