Mucosectomy band ligation as a treatment for in situ esophageal carcinoma.

Esophageal squamous cell carcinoma (ESCC) remains the most prevalent subtype of esophageal cancer worldwide. Major risk factors include chronic alcohol consumption and heavy smoking. We present the case of a 65-year-old male with chronic alcoholism and a 75 pack-year smoking history, admitted for his first hydropic decompensation of alcoholic cirrhosis. The patient presented with abdominal distension and discomfort. Physical examination confirmed ascites, and further evaluation indicated decompensated cirrhosis. An upper gastrointestinal endoscopy revealed a 15 mm flat mucosal lesion located 35 cm from the dental arcade, classified as IIb according to the Paris Classification. The lesion had a denuded surface, and narrow band imaging (NBI) showed a brownish appearance with abnormal intrapapillary capillary loops (IPCL), suggesting a degenerative squamous lesion of the esophagus. A computed tomography (CT) scan showed no signs of distant metastasis. Histopathological examination of biopsies confirmed high-grade dysplasia (carcinoma in situ).