A 65-year-old man had been receiving yearly esophagogastroduodenoscopy (EGD) at another hospital. A type 0-IIc lesion was found at the midthoracic esophagus, and he visited our hospital. We performed EGD and white light imaging revealed a shallow depressed lesion of about 10-mm diameter. The lesion was seen as a brownish area on NBI, and a unstained area by iodine staining. Magnifying endoscopy showed few intraepithelial papillary capillary loop area. We could not determine whether the tumor was malignant. Although histological examination of biopsy specimens showed evidence of inflammation, endoscopic findings suggested carcinoma. Thus, we performed endoscopic submucosal dissection (ESD) for diagnosis and treatment. Histopathological findings were squamous cell carcinoma, and depth was SM2. The surface differentiation was maintained and it might be reflected in the endoscopic findings. In this particular case, ESD was useful for diagnosis.
