Thallium-201 (Tl-201) has primarily been used as a myocardial perfusion agent, but its use as a tumor agent has detected many kinds of malignancies. However, scintigraphic detection of esophageal cancer with lymph node metastasis in the neck and mediastinum by TI-201 has not been reported previously. ( Mid Taiwan J Med 2002;7:55-8)