Endoscopic resection of esophageal adenoid cystic carcinoma with submucosal origin and long-term follow-up: a case report.

Esophageal adenoid cystic carcinoma (EACC) is an exceptionally rare malignancy where diagnosis by conventional endoscopy remains challenging due to its submucosal growth pattern. We present a case of a 47-years-old male with an esophageal submucosal lesion detected during routine examination. Endoscopic ultrasound (EUS) precisely localized the lesion to the submucosal layer, revealing a hypoechoic mass with a characteristic sieve-like appearance and intact muscularis propria. The tumor was completely resected using endoscopic submucosal excavation (ESE), with histopathology confirming EACC. During 5 years of regular follow-up, the patient maintained excellent condition with no evidence of recurrence or metastasis. This case highlights the critical role of EUS in diagnosing and staging early EACC and demonstrates that endoscopic resection can achieve long-term cure in carefully selected patients, offering a minimally invasive alternative to traditional esophagectomy.