{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:10:06Z","timestamp":1779253806325,"version":"3.51.4"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Benign-appearing gastrointestinal lesions may occasionally conceal malignancy and pose a diagnostic challenge. Esophageal leiomyomas are benign neoplasms; however, careful mucosal assessment remains essential to avoid missed diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description<\/jats:title>\n                    <jats:p>\n                      We report the case of a 53-year-old asymptomatic woman in whom a large esophageal leiomyoma masked a superficial esophageal squamous cell carcinoma (ESCC). Subtle mucosal irregularity detected on endoscopy prompted further evaluation with narrow-band imaging and targeted biopsies, confirming carcinoma\n                      <jats:italic>in situ<\/jats:italic>\n                      . Following multidisciplinary discussion and shared decision-making that incorporated patient preferences, selective endoscopic submucosal dissection (ESD) was performed to achieve complete resection of the carcinoma while preserving the underlying leiomyoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>En bloc resection was achieved without complications. Histopathology confirmed a well-differentiated superficial ESCC with submucosal invasion (&amp;gt;200 \u03bcm, pT1b), negative horizontal and vertical margins, and no lymphovascular invasion. After postoperative pathology review, additional surgical treatment was recommended because of the risk associated with submucosal invasion; however, the patient strongly declined surgery. Contrast-enhanced CT showed no evidence of regional lymph node metastasis, and the patient subsequently underwent radiotherapy at a local hospital. At 2-year follow-up, endoscopic re-examination showed no recurrence, and the leiomyoma remained stable in size. This case underscores the importance of careful evaluation for occult malignancy hidden behind benign-appearing lesions and demonstrates that favorable outcomes can be achieved through individualized, multidisciplinary management, including endoscopic resection, adjuvant therapy, and close surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1819413","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:43:57Z","timestamp":1779252237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Complete endoscopic submucosal dissection for occult superficial esophageal squamous cell carcinoma concealed by a large esophageal leiomyoma"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoying","family":"Yang","sequence":"first","affiliation":[{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaowen","family":"Hu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wangyang","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shengyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonglin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Zhejiang Provincial People\u2019s Hospital, Hangzhou Medical College","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"He","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College","place":["Beijing, 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