The patient was a 64-year-old male suffering from alcoholic liver cirrhosis and esophageal varices. The follow-up endoscopy revealed the aggravation of esophageal varices and superficial esophageal carcinoma. Subsequent endoscopic ultrasonography disclosed the perforating vein of varices on the anal margin of esophageal carcinoma. Accordingly endoscopic variceal ligation (EVL) was conducted as the treatment for the varices. Then the decrement of the varices was confirmed by endoscopic ultrasonography. Afterward endoscopic mucosal resection (EMR) was employed as the treatment for esophageal carcinoma. EMR was safely performed without inducing bleeding and complications.
Several cases of esophageal varices complicated with esophageal carcinoma have been reported. In this case, however, esophageal carcinoma existed on the perforating vein of esophageal varices and the immediate risk of EMR seemed to be high. The adoption of endoscopic ultrasonography before and after the endoscopic therapy was useful and secured safer treatment.
