Esophagitis is described as an inflammation of the esophagus and can result from multiple etiologies. Esophageal squamous cell carcinoma (ESCC), presenting as diffuse esophagitis in the absence of a mass or lesion, is rare. We present a case of a 61-year-old man who presented to the gastroenterology clinic for dysphagia and heartburn of 3 months duration. The patient had lost about 15 pounds unintentionally over 6 months. The patient underwent esophagogastroduodenoscopy, which revealed significant diffuse Grade 4 esophagitis without any overt bleeding. Random biopsies were taken with cold forceps from proximal, middle, and distal esophageal segments because of the striking endoscopic appearance. Histopathology revealed high-grade dysplasia and carcinoma in situ. The patient underwent endoscopic ultrasound (EUS) of the esophagus, which revealed a focal lesion. EUS-guided fine-needle aspiration showed squamous cell carcinoma of the esophagus. ESCC usually presents as a mass or a gross lesion seen on endoscopy. However, it rarely presents as severe diffuse esophagitis seen on routine endoscopy. From our observation, it would be reasonable for physicians to bear this unusual endoscopic presentation in mind and perform multiple random biopsies if encountered with such a case to rule out the possibility of any underlying malignancy.
Case Rep Gastroenterol 2021;15:533–538

中文翻译：

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伪装成弥漫性重度食管炎的食管鳞状细胞癌的非典型表现

食道炎被描述为食道的炎症，可由多种病因引起。食管鳞状细胞癌 (ESCC) 在没有肿块或病变的情况下表现为弥漫性食管炎，这是罕见的。我们介绍了一个案例，一名 61 岁的男性因吞咽困难和胃灼热而到胃肠病诊所就诊，持续时间为 3 个月。患者在 6 个月内无意中减掉了约 15 磅。患者接受了食管胃十二指肠镜检查，结果显示明显的弥漫性 4 级食管炎，没有任何明显出血。由于引人注目的内窥镜外观，使用冷钳从近端、中端和远端食管段进行随机活检。组织病理学显示高度不典型增生和原位癌。患者接受了食管内窥镜超声 (EUS)，这揭示了一个局灶性病变。EUS 引导下的细针穿刺显示食管鳞状细胞癌。ESCC 通常表现为内窥镜检查发现的肿块或肉眼可见的病变。然而，它很少表现为常规内窥镜检查中看到的严重弥漫性食管炎。根据我们的观察，如果遇到这种情况，医生有理由记住这种不寻常的内窥镜表现并进行多次随机活检以排除任何潜在恶性肿瘤的可能性。
Case Rep Gastroenterol 2021；15:533–538