Early Uvular Cancer Detected by Esophagogastroduodenoscopy

Abstract

A 70-year-old man underwent screening esophagogastroduodenoscopy. He had a history of smoking 50 cigarettes and drinking 63 g of alcohol per day for the past 40 years. Esophagogastroduodenoscopy revealed redness and small nodules on the uvula (Picture 1A). Narrow-band imaging (NBI) with magnification revealed irregular microvessels with a loop-like formation, which was classified as type B1, according to the magnifying endoscopic classification for superficial esophageal cancer proposed by the Japan Esophageal Society (Picture 1B) Based on these findings, the lesion was suspected to be early uvular cancer confined to the subepithelium. A biopsy revealed squamous cell carcinoma (Picture 2), and a diagnosis of uvular cancer was made. Computed tomography revealed no lymph node/distant metastasis. Given these findings, the patient was finally diagnosed with clinical stage I disease, according to the Union for International Cancer Control TNM classification. He received radiation therapy, and the endoscopic findings of the uvula improved (Picture 3A, white-light imaging; 3B, NBI imaging). Uvular cancer is a rare disease, accounting for 1.3% of cases of oropharynx cancer (1). Uvular cancer arises mainly in men with a smoking and/or alcohol drinking history with a wide age group. The visual features of uvular cancer include red or small nodules on the uvula, such as in