A case of superficial esophageal carcinoma with papilloma resected by en bloc endoscopic submucosal dissection

A 71-year-old man underwent upper gastrointestinal endoscopy, and a slightly protruded lesion was detected 26 cm from the incisors. Biopsy specimen revealed chronic esophagitis. One year later, re-examination with upper gastrointestinal endoscopy showed persistence of the protruded lesion and also new findings of a slightly depressed and erythematous lesion at the opposite side. He was admitted to our hospital, and histological examination of the biopsy specimens from upper gastrointestinal endoscopy revealed concomitant squamous cell papilloma and squamous cell carcinoma. [18F]-fluorodeoxyglucose (FDG) accumulated in the squamous cell papilloma and/or in the mucosal squamous cell cancer. Endoscopic submucosal dissection was performed. Human papillomavirus (HPV) 16/18 was not detected in either lesion. Concomitant esophageal papilloma and esophageal squamous cell carcinoma is extremely rare. Additional study is required to characterize the etiology, diagnosis (including FDG accumulation), and clinical course of this phenomenon. The relationship between HPV infection and esophageal squamous cell carcinoma is reviewed.