The patient was a woman in her 60s. A lesion was pointed out by esophagography at a health checkup. Endoscopy showed a white granular elevated lesion at 34 to 40 cm from the incisor teeth. Since she was initially diagnosed with candida esophagitis, antifungal drug was administered but no change was observed. Six years later, endoscopic examination showed morphological changes in the lesion, and it was diagnosed as 0-IIc-type early esophageal cancer. Endoscopic mucosal resection was performed, and it was pathologically diagnosed as pT1a-MM, ly0, v0. The tumor may have originally existed under the keratinized epithelium. Or cancer may have been caused by prolonged chronic inflammation such as reflux esophagitis.