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Squamous cell carcinoma (SCC) can appear synchronously in the upper aerodigestive tract and in the esophagus by the mechanism of field cancerization, as tobacco and alcohol are both major risk factors for these lesions [1, 2]. Narrowband imaging (NBI) and Lugol chromoendoscopy are the standard techniques for assessment of superficial esophageal lesions, although Lugol staining can lead to adverse events, such as mucosal irritation, allergic reactions, and aspiration, especially in the oropharyngeal area. NBI has proven to be superior to white-light imaging (WLI), with significantly higher diagnostic sensitivity in the detection of superficial mucosal lesions of the esophagus and pharynx [3], by showing altered intrapapillary capillary loop (IPCL) pattern [4]. ▶ Fig. 1 Esophageal epidermoid lesion. a, c Appearance with white-light imaging. b, d Appearance with narrow-band imaging.

Narrow-band imaging detects synchronous oropharyngeal squamous carcinoma during treatment of an early esophageal squamous cell carcinoma