The patient was a 56-year-old male who was seen in a hospital in 2007 for retrosternal discomfort. gastroscopy revealed a bulging lesion in the middle esophagus with surface mucosal erosion, ultrasound endoscopy suggested smooth muscle tumor, endoscopic treatment was performed, postoperative pathology confirmed esophageal cancer, additional surgical open-heart radical esophageal cancer surgery, postoperative recovery was still good. 1 month ago, a new bulge was found 3 cm above the anastomosis, NBI suggested The mucosal surface vascular network was disturbed and there were more neovascularization of tumor. Ultrasound endoscopy suggested hypoechoic changes in the local lesion, and the biopsy result was squamous cell carcinoma. Since the patient had a history of radical esophageal cancer surgery, it was difficult to perform radical surgery again. The patient repeatedly considered and gave up radiotherapy and chose palliative endoscopic resection. Ling Tingsheng, Department of Gastroenterology, Nanjing Gulou Hospital