Treatment of esophageal cancer and recent advances in the diagnosis have improved patient survival after esophagectomy. We experienced a case of ESD for GTC, which was occurenced on the suture line of a reconstructed gastric tube (GT) after esophagectomy. The patient was a 73-year old man who had received esophagectomy with reconstruction of the GT for esophageal squamous cell carcinoma. Three years later, endoscopy showed a slightly depressed mucosal lesion (0-IIc) with red-colored mucosa was found on the suture line of the GT. It was diagnosed as a well differentiated tubular adenocarcinoma, and we performed ESD without complication. ESD for GTC after esophagectomy is a technically difficult because of the limited working space and the presence of gastric fibrosis with staples under the suture line, but considered a useful treatment.
