Clin Endosc.  2019 Jan;52(1):72-75. 10.5946/ce.2018.058.

A Case of Esophageal Squamous Cell Carcinoma in situ Arising from Esophageal Squamous Papilloma

  • 1Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 2Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea.


Squamous papilloma is a common benign tumor of the esophagus. Patients with papilloma are usually asymptomatic, and they are diagnosed incidentally during esophagogastroduodenoscopy. Most papillomas are small and easily removed by forceps biopsy. Recurrence of papilloma after removal is rare. Human papilloma virus infection is supposed to play a role in the development of esophageal papilloma; however, malignant transformation of papilloma is extremely unusual. Here, we report a case of malignant transformation of esophageal squamous papilloma at the gastroesophageal junction into squamous cell carcinoma in situ, which was treated by endoscopic submucosal dissection.


Papilloma; Carcinoma, squamous cell; Carcinoma in situ; Endoscopy, digestive system

MeSH Terms

Carcinoma in Situ
Carcinoma, Squamous Cell*
Endoscopy, Digestive System
Epithelial Cells*
Esophagogastric Junction
Surgical Instruments


  • Fig. 1. Endoscopic appearance. A round, protruding polyp measuring 1.0 cm, located at the squamocolumnar junction of the gastroesophageal junction. The polyp had lobulated surface and slight nodularity, and the surface glossiness seemed intact.

  • Fig. 2. Histologic findings of the specimen. Microscopic examination revealed squamous papilloma with papillary epithelial proliferation with the fibrovascular core at low-power magnification (A, Hematoxylin and eosin [H&E] stain, ×40). The squamous cell showed koilocytosis with nuclear irregularity and perinuclear halo (B, H&E stain, ×200).

  • Fig. 3. Endoscopic appearance. A polyp recurred at the squamocolumnar junction of the gastroesophageal junction at the same spot where the papilloma had been removed 2 years previously. The polyp had a smooth surface with shallow lobulation. Gross examination was not suggestive of dysplasia or carcinoma.

  • Fig. 4. Gross appearance of the resected specimen by endoscopic submucosal dissection technique. A specimen measuring 3.0×2.8 cm, including a protruding mass at the 3 o’clock position, was resected en bloc. The oral side had a relatively narrow free margin, contrary to the anal side (9 o’clock position). Grossly, the circumferential lateral margin was free from polyp involvement.

  • Fig. 5. Histologic findings of the specimen. The polyp showed usual morphological features of squamous papilloma at low-power magnification (A, Hematoxylin and eosin [H&E] stain, ×40) but multifocal severe squamous atypia throughout the mucosal epithelium, which was compatible with squamous carcinoma in situ (B, H&E stain, ×200).


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