Gastrointestinal Endoscopy-Assisted Minimally Invasive Surgery for Superficial Cancer of the Uvula

Abstract

Previous studies reported that endoscopic resection is effective for the treatment of superficial pharyngeal cancers, as for digestive tract cancers. However, the optimal treatment for superficial cancer of the uvula has not been established because of the rarity of this condition. We present two male patients in their 70s with superficial cancer of the uvula, detected with upper gastrointestinal endoscopy. Both patients underwent surgical resection of the uvula under general anesthesia. The extent of the lesions was determined by means of gastrointestinal endoscopy by using magnifying observation with narrow-band imaging, enabling the performance of minimally invasive surgery. Endoscopic submucosal dissection was performed to achieve en bloc resection of the intramucosal carcinoma that had infiltrated the area adjacent to the uvula. Gastrointestinal endoscopists should carefully examine the laryngopharynx to avoid missing superficial cancers. Our minimally invasive treatment for superficial cancer of the uvula had favorable postoperative outcomes, and prevented postoperative loss of breathing, swallowing, and articulation functions.

Tailored resections in oral and oropharyngeal cancer using narrow band imaging

“…The intra-operative use of NBI has yielded excellent results during transoral laser surgery for early glottic cancer [20] and surgical resection of oropharyngeal cancers [21][22][23][24]. Our group was the first to report on the intra-operative use of NBI in oral cancer as well [10,25,26].…”

Early Uvular Cancer Detected by Esophagogastroduodenoscopy

“…this case (2). Therefore, in patients with a habit of heavy smoking and drinking, careful endoscopic observation of the oropharyngeal area with a focus on subtle mucosal changes may allow for the early detection of uvular cancer.…”

Endoscopic submucosal dissection for pharyngeal cancer: removal of supra-oropharyngeal cancer

“…In almost all previous reports of superficial pharyngeal cancer, the lesion occurred in the pyriform sinus or the posterior or lateral pharyngeal wall or the uvula. 3 , 4 ESD for an oral lesion is challenging because of the difficulty of obtaining an unobstructed field of view (working space) owing to the presence of the tongue and narrow lumen. In the present case, several distinctive innovations were used to perform the ESD.…”