Asian Journal of Case Reports in Surgery

Introduction: Mucoepidermoid Carcinoma (MEC) is a rare variety of esophageal primary cancers with a global incidence of merely 1%. The clinical presentation of this cancer is indistinguishable from the common varieties of esophageal cancers, without any characteristic features of its own, leading to a diagnostic dilemma with final confirmation obtained only on histopathological examination. Being aggressive and unresponsive to chemotherapy or radiotherapy, surgical resection is the primary treatment modality for this type of cancer, and quite possibly, curative.

Case: We present the case of a 58-year-old lady who presented with pain in epigastrium, on and off loose stools, and dysphagia for one year. With no comorbidity and no significant family history, patient’s only risk factor was beedi smoking since past 10 years. While the patient had unremarkable examination findings and normal routine blood investigations, upper gastrointestinal endoscopy (UGIE) reported a growth in distal esophagus.

Diagnosis & Management: Endoscopic biopsy revealed moderately differentiated squamous cell carcinoma (SCC), however, no growth or mass lesion was seen in computed tomography (CT) scan of the patient. She underwent Trans-hiatal Esophagectomy with cervical esophagogastrostomy and was subsequently discharged. Final histopathological report confirmed MEC Esophagus.

Conclusion: MEC should be considered as a differential diagnosis in patients presenting with clinical features of esophageal cancer, particularly if no mass lesion or growth is visible on imaging, as highlighted by this case.