Abstract
A case of carcinosarcoma arising from the area of intraepithelial spread of relapsed esophageal squamous cell carcinoma (SCC) after definitive chemoradiotherapy (CRT) is reported herein. A 71-year-old man was referred to our hospital because of a superficial esophageal carcinoma. Definitive CRT was performed because the patient refused surgical treatment. Complete response was recognized after CRT, but tumor relapse was diagnosed 3 months later. The relapsed tumor initially revealed a minimal depression with a small white nodule. This nodule developed to a sessile elevated mass after 1 month and finally to a polypoid tumor 3.2 × 2.3 × 1.5 cm in size within 125 days. A subtotal esophagectomy with two-field lymph node dissection was performed. Histologically, the polypoid tumor was composed mainly of spindle-shaped sarcomatous cells and invaded the muscularis propria of the esophageal wall. An area of intraepithelial spread of SCC was found at the base of its stalk. No lymph node metastases were found. The postoperative course was uneventful, and the patient has remained free of disease for 45 months. To our knowledge, this is the only reported case of esophageal carcinosarcoma arising from an area of intraepithelial spread of relapsed SCC that showed such rapid growth by serial endoscopies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Iyomasa S, Kato H, Tachimori Y, Watanabe H, Yamaguchi H, Itabashi M. Carcinosarcoma of the esophagus: a twenty-case study. Jpn J Clin Oncol 1990;20:99–106.
Taniyama K, Sasaki N, Mukai T, Uemura N, Miyoshi N, Nakai N, et al. Carcinosarcomas of the esophagus. Pathol Int 1995;45: 297–302.
Wang ZY, Itabashi M, Hirota T, Watanabe H, Kato H. Immunohistochemical study of the histogenesis of esophageal carcinosarcoma. Jpn J Clin Oncol 1992;22:377–386.
Iwaya T, Maesawa C, Tamura G, Sato N, Ikeda K, Sasaki A, et al. Esophageal carcinosarcoma: a genetic analysis. Gastroenterology 1997;113:973–977.
Matsumoto T, Fujii H, Arakawa A, Yamasaki S, Sonoue H, Hattori K, et al. Loss of heterozygosity analysis shows monoclonal evolution with frequent genetic progression and divergence in esophageal carcinosarcoma. Hum Pathol 2004;35:322–327.
Sasajima K, Taniguchi Y, Morino K, Yamashita K, Onda M, Hao K, et al. Rapid growth of a pseudosarcoma of the esophagus. J Clin Gastroenterol 1988;10:533–536.
Uchiyama S, Imai S, Hoshino A, Obara K, Yoshida K, Kodama H, et al. Rapid-growing carcinosarcoma of the esophagus arising from intraepithelial squamous cell carcinoma: report of a case. Surg Today 2000;30:173–176.
Sobin LH, Wittekind CH. TNM classification of malignant tumors. 6th ed. New York: Wiley-Liss; 2002.
The Japan Esophageal Society. Guidelines for the clinical and pathologic studies on carcinoma of the esophagus. 10th ed. Tokyo: Kanehara; 2007.
The Japan Society for Esophageal Diseases. Comprehensive registry of esophageal cancer in Japan. 3rd ed. Tokyo: Japan Society for Esophageal Diseases; 2002.
Battrifora H. Ultrastructural evidence of squamous origin and collagen production by the tumor cells. Cancer (Phila) 1976;37: 2275–2282.
Takagi I, Kawasawa K. Growth of squamous cell esophageal carcinoma observed by serial esophagographies. J Surg Oncol 1982;21:57–60.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nakagawa, S., Yabusaki, H. & Tanaka, O. Rapid-growth carcinosarcoma of the esophagus arising from 0-IIc squamous cell carcinoma after definitive chemoradiotherapy: a case report. Esophagus 6, 123–126 (2009). https://doi.org/10.1007/s10388-008-0181-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10388-008-0181-9