Clin Endosc.  2013 Mar;46(2):189-192. 10.5946/ce.2013.46.2.189.

Endoscopic Resection of Hypopharyngeal Squamous Cell Carcinoma

• Bok GH
• Cho WY
• Cho JY
• Jin SY
• Ahn JH
• Chun CG
• Lee TH
• Kim HG

• KMID: 1805304
• DOI: http://doi.org/10.5946/ce.2013.46.2.189

Abstract

Hypopharyngeal cancers are often diagnosed at an advanced stage and have a poor prognosis. Even when they are diagnosed at an operable stage, surgery often results in substantial morbidity and decreased patients' quality of life. Although the endoscopic diagnosis of early hypopharyngeal cancer is difficult, recent developments in advanced imaging endoscopy have enabled easier diagnosis of these lesions. Endoscopic resection of early hypopharyngeal cancer is a potential minimally invasive treatment that can preserve the function and quality of life of patients. Reports of this procedure are limited, however. We report a case of hypopharygeal cancer treated with endoscopic resection.

Keyword

Hypopharyngeal neoplasms; Carcinoma, squamous cell; Endoscopic mucosal resection

MeSH Terms

Carcinoma, Squamous Cell
Endoscopy
Humans
Hypopharyngeal Neoplasms
Prognosis
Quality of Life

Figure

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  Fig. 1 Endoscopic findings of the hypopharynx. (A) A hyperemic elevated lesion in observed at the right pyriform recess (yellow arrow). (B) Narrow band imaging (NBI) shows a type V irregular intrapapillary capillary loops pattern. (C) A slightly depressed mucosal lesion at the left pyriform recess (yellow arrow) is seen on follow up endoscopy. (D) NBI shows an irregular vascular pattern.

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  Fig. 2 Gross and pathologic mapping findings of the resected lesions. (A) Specimen from right pyriform recess. A hyperemic elevated lesion measuring approximately 7×3 mm in observed in the center of the specimen. (B) Pathologic mapping shows the lesion in orange with free lateral margins. (C) Specimen from left pyriform recess. A minute mucosal lesion is observed at the upper left hand corner of the specimen. (D) Pathologic mapping show the lesion in orange with free lateral margins.

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  Fig. 3 Microscopic findings of the resected lesion. Top; right pyriform recess. (A, B) The entire epithelial layer is replaced by atypical squamous epithelial cells, (C) accompanied by diffuse strong p53 protein overexpression in their nuclei. Bottom; left pyriform recess. (D, E) The squamous cells in the lower one-third of the epithelial layer is atypical, (F) where p53 protein overexpression can be identified (A, D, H&E stain, ×40; B, E, H&E stain, ×100; C, F, p53, ×100).

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