Successful balloon-based radiofrequency ablation of a widespread early squamous cell carcinoma and high-grade dysplasia of the esophagus: a case report

BackgroundFor selected patients with high-grade dysplasia (HGD) and/or early esophageal squamous cell cancer (ESCC), endoscopic therapy represents a nonsurgical treatment option. For widespread lesions, however, current endoscopic treatment modalities (eg, endoscopic resection, argon plasma coagulation, photodynamic therapy) are associated with considerable drawbacks, of which esophageal stricturing is the most significant. Balloon-based radiofrequency (RF) ablation (HALO System) is a promising technology for endoscopic treatment of Barrett's esophagus, and may also play a role in treating widespread HGD and early ESCC.ObjectiveWe describe a case report of balloon-based RF ablation for HGD and early ESCC.DesignCase report.SettingTertiary care institution, Academic Medical Center, Amsterdam, The Netherlands.PatientA 66-year-old male with a 35-mm large, flat-type ESCC with surrounding HGD.InterventionBalloon-based RF ablation (HALO System).Main Outcome MeasurementsEndoscopic and histological eradication of HGD and ESCC, and adverse events.ResultsRF ablation resulted in complete endoscopic and histological eradication of HGD and ESCC without adverse events such as dysphagia or esophageal narrowing.LimitationsSingle patient report, limited follow-up.ConclusionsThis is the first report of balloon-based RF ablation for esophageal HGD and early ESCC. The treatment resulted in complete eradication of a 35-mm flat ESCC with no adverse events. This suggests that this ablation technique deserves further study for the management of widespread HGD or flat-type ESCC.