Post written by Kotaro Waki, MD, from the Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.

We previously reported that 3 endoscopic findings of melanosis, whitish epithelium, and vasodilation in the soft palate are associated with a high risk of esophageal squamous cell carcinoma (ESCC) and are considered useful as indicators of ESCC. In this case series, we showed the 3 ESCC cases with the remarkable findings in the soft palate using a new endoscopic system with enhanced depth-offield (EDOF) imaging technology (GIF-EZ1500 and EVIS X1 CV-1500, Olympus Co, Tokyo, Japan).

Conventional endoscopic systems required magnified observation to evaluate one of the findings, vasodilation, in the soft palate, which is a little complicated. However, our presented cases showed that EDOF imaging technology enabled us to evaluate vasodilation without magnification and also provided clearer images. We feel it important that the new system makes it easier to observe the soft palate.

The effective detection of ESCC requires the identification of patients at high risk of ESCC and a detailed inspection of the esophagus. The endoscopic findings in the soft palate are useful for the identification of patients at high risk of ESCC at the start of upper endoscopy and EDOF imaging technology enables us to evaluate the findings easier. If the findings in the soft palate are present, the esophagus should be meticulously observed with NBI/blue laser imaging or Lugol chromoendoscopy. In addition, we consider these soft palate findings were applicable during health screening or dental examinations, as the soft palate can be observed via visual inspection.

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