A 74-year-old man with
nausea underwent upper gastrointestinal endoscopy, and a 0-IIb type
tumor was found in the middle thoracic esophagus. Histological examination with endoscopic biopsies revealed
squamous cell carcinoma (SCC), and chromoendoscopy with
iodine staining revealed that the superficial SCC involved nearly the entire circumference of the esophageal lumen. There were neither nodal nor distant
metastases. Complete circular endoscopic submucosal dissection (ESD) was successfully achieved with
tumor-free margins in an en bloc fashion. The histopathological examination confirmed a diagnosis of intramucosal invasive
carcinoma limited to the lamina propria mucosae without angiolymphatic invasion. Oral
prednisolone was started with 0.5 mg/kg daily on the 3rd post-ESD day, tapered gradually, and then discontinued 8 weeks later without adverse effects. There were no complaints of
dysphagia following ESD. On follow-up endoscopy with
iodine staining, which was scheduled at 1, 3 and 6 months after ESD, there was no postprocedural
esophageal stricture, and neither recurrent nor metachronous lesions were found. Thus, the patient required no sessions of endoscopic balloon dilatation. At the last outpatient clinic visit 7 months after ESD, he remained well without
dysphagia. Oral
prednisolone administration may offer an effective therapeutic strategy to prevent the post-ESD
esophageal stricture after complete circular ESD.