Cancer arising in lichen planus of the esophagus (LPE) is extremely rare. We report 2 elderly female patients with LPE who developed squamous cell carcinoma. Both underwent laparoscopic ischemic gastric preconditioning followed 2 weeks later by 3-field esophagectomy. Final pathological stages were carcinoma in situ and pT3N2, respectively. No adjuvant therapy was given. The patient with in situ cancer has no evidence of recurrence at 24 months. The second patient opted to follow up locally and died 8 months later. LPE should be closely monitored for malignant degeneration. Esophagectomy should be considered when malignancy is detected.
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