Case Report and retrospective literature analysis of pediatric lower esophageal squamous cell carcinoma: focus on diagnostic challenges and therapeutic strategies

Malignant solid tumors of the gastrointestinal tract are clinically rare in children, with malignant solid tumors of the esophagus being particularly uncommon. Clinical reports on esophageal cancer in children are extremely scarce. This report describes a case of lower esophageal squamous cell carcinoma in a 10-year-old male child. By integrating the clinical management process and relevant literature, we analyze the clinical characteristics, diagnostic and therapeutic key points, and prognostic factors of pediatric esophageal squamous cell carcinoma, aiming to provide reference for its clinical management. The patient was admitted for “vomiting for 1 month” and diagnosed with stage IIIA (T1N2M0) squamous cell carcinoma of the lower esophagus. Despite treatment including chemotherapy and laparoscopic gastrostomy, the disease progressed, and the patient died 7 months after diagnosis. Pediatric esophageal squamous cell carcinoma is often diagnosed at an advanced stage with poor prognosis. Its clinical manifestations lack specificity, and no definitive treatment protocol currently exists. It differs significantly from adult tumors in clinical presentation and management strategies, not merely representing a “miniature version” of adult tumors. Currently, no standardized treatment exists for pediatric esophageal squamous cell carcinoma. Available evidence, derived primarily from adult studies and isolated pediatric case reports, suggests that a comprehensive approach combining neoadjuvant chemoradiotherapy with surgery may be cautiously considered in selected pediatric patients. Delaying surgery until tumor downstaging and optimal surgical timing are achieved may potentially improve survival outcomes for these patients.