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Primary mucoepidermoid carcinoma of the esophagus: review of the literature

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Abstract

Mucoepidermoid carcinoma of the esophagus (MECE) is an unusual variant of esophageal cancer composed of a mixture of mucus-secreting adenocarcinoma and squamous cell carcinoma. Its pathological interpretation and nomenclature have altered, and even at the present time, two different theories to account for its histological origin can be considered. Previous reports have indicated that MECE shows aggressive biological behavior and has a poor prognosis. However, because of its rarity, the clinicopathological features have not been fully investigated. We collected 125 reported cases of MECE and analyzed their features. The median patient age was 62 years (range 40–92 years) and a male predominance was noted with a male:female ratio of 3.2:1. MECE preferentially occurs in the middle part of the thoracic esophagus. Lymph node metastasis was present in 53.8 % of advanced (T2–4) cases and 21.4 % of T1 cases. The outcome of MECE appears to have improved significantly during the past two decades (P < 0.01). However, survival period did not differ between patients undergoing surgery alone (n = 65) and those receiving additional chemo/radiotherapy (n = 28, P = 0.43). Cox multivariate regression analysis revealed that the presence of lymph node metastasis (P < 0.01) and male gender (P = 0.01) were independent factors negatively impacting survival.

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References

  1. Takubo K. Carcinomas other than squamous cell carcinoma and adenocarcinoma. In: Takubo K, editor. Pathology of the Esophagus. Springer, New York; 2007, pp. 212–225.

  2. Ozawa S, Tachimori Y, Baba H, Fujishiro M, Matsubara H, Numasaki H, et al. Comprehensive registry of esophageal cancer in Japan, 2004. Esophagus. 2012;9(2):75–98.

    Article  Google Scholar 

  3. Suzuki H, Nagayo T. Primary tumor of the esophagus other than squamous cell carcinoma: histologic classification and statics in the surgical and autopsied materials in Japan. Int Adv Surg Oncol. 1980;3:73–109.

    PubMed  CAS  Google Scholar 

  4. Chen S, Chen Y, Yang J, Yang W, Weng H, Li H, et al. Primary mucoepidermoid carcinoma of the esophagus. J Thorac Oncol. 2011;6(8):1426–31.

    Article  PubMed  Google Scholar 

  5. Lieberman MD, Franceschi D, Marsan B, Burt M. Esophageal carcinoma. The unusual variants. J Thorac Cardiovasc Surg. 1994;108(6):1138–46.

    PubMed  CAS  Google Scholar 

  6. Lam KY, Dickens P, Loke SL, Fok M, Ma L, Wong J. Squamous cell carcinoma of the oesophagus with mucin-secreting component (muco-epidermoid carcinoma and adenosquamous carcinoma): a clinicopathologic study and a review of literature. Eur J Surg Oncol. 1994;20(1):25–31 Review.

    PubMed  CAS  Google Scholar 

  7. Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumors. 7th ed. Oxford: Wiley-Blackwell; 2010.

    Google Scholar 

  8. The Japan Esophageal Society. Japanese classification of esophageal cancer, tenth edition: part 1. Esophagus. 2009;6(1):1–25.

    Article  Google Scholar 

  9. McPeak E, Arens WL. Adenoacanthoma of esophagus: report of one case with consideration of the tumor’s resemblance to so-called salivary gland tumor. Arch Pathol Lab Med. 1947;44(4):385–90.

    CAS  Google Scholar 

  10. Murakami M, Shimizu Y, Kameyama H, Fukoe Y, Kameyama S, Kusano M. Report of a case of mucoepidermoid carcinoma of the esophagus. Dig Endosc. 1998;10(1):51–4.

    Article  Google Scholar 

  11. Tamura S, Kobayashi K, Seki Y, Matsuyama J, Kagara N, Ukei T, et al. Mucoepidermoid carcinoma of the esophagus treated by endoscopic mucosal resection. Dis Esophagus. 2003;16(3):265–7.

    Article  PubMed  CAS  Google Scholar 

  12. Osamura RY, Sato S, Miwa M, Miwa T. Mucoepidermoid carcinoma of the esophagus. Am J Gastroenterol. 1978;69(4):467–70.

    PubMed  CAS  Google Scholar 

  13. Matsufuji H, Kuwano H, Ueo H, Sugimachi K, Inokuchi K. Mucoepidermoid carcinoma of the esophagus—a case report. Jpn J Surg. 1985;15(1):55–9.

    Article  PubMed  CAS  Google Scholar 

  14. Takubo K, Takai A, Yamashita K, Onda M. Carcinoma with signet ring cells of the esophagus. Acta Pathol Jpn. 1987;37(6):989–95.

    PubMed  CAS  Google Scholar 

  15. Ozawa S, And N, Shinozawa Y, Ohmori T, Kase K, Sato T, et al. Two cases of resected esophageal mucoepidermoid carcinoma. Jpn J Surg. 1989;19(1):86–92.

    Article  PubMed  CAS  Google Scholar 

  16. Sasajima K, Watanabe M, Takubo K, Takai A, Yamashita K, Onda M. Mucoepidermoid carcinoma of the esophagus: report of two cases and review of the literature. Endoscopy. 1990;22(3):140–3 Review.

    Article  PubMed  CAS  Google Scholar 

  17. Koide N, Hamanaka K, Igarashi J, Hanazaki K, Adachi W, Hosaka S, et al. Co-occurrence of mucoepidermoid carcinoma and squamous cell carcinoma of the esophagus: report of a case. Surg Today. 2000;30(7):636–42.

    Article  PubMed  CAS  Google Scholar 

  18. Azzopardi JG, Menzies T. Primary oesophageal adenocarcinoma: confirmation of its existence by findings of mucous gland tumors. Br J Surg. 1962;49:497–506.

    Article  PubMed  CAS  Google Scholar 

  19. Raven RW. Rare tumors of the pharynx and esophagus. Ann Acad Sci. 1964;114:1061–74.

    Article  Google Scholar 

  20. Raphael HA, Ellis FH Jr, Dockerty MB. Primary adenocarcinoma of the esophagus: 18 year review and review of the literature. Ann Surg. 1966;164(5):785–96.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  21. Lortat-Jacob JL, Maiillard JN, Richard CA, Fékété F, Huguier M, Conte-Marti J. Primary esophageal adenocarcinoma: report of 16 cases. Surgery. 1968;64(3):535–43.

    PubMed  CAS  Google Scholar 

  22. Kay S. Mucoepidermoid carcinoma of the esophagus: report of two cases. Cancer. 1968;22(5):1053–9.

    Article  PubMed  CAS  Google Scholar 

  23. Weitzner S. Mucoepidermoid carcinoma of the esophagus: report of a case. Arch Pathol. 1970;90(3):271–3.

    PubMed  CAS  Google Scholar 

  24. Turnbull AD, Rosen P, Goodner JT, Beattie EJ. Malignant tumors of the esophagus other than typical epidermoid carcinoma. Ann Thorac Surg. 1973;15(5):463–73.

    Article  PubMed  CAS  Google Scholar 

  25. Woodard BH, Shelburne JD, Vollmer RT, Postlethwait RW. Mucoepidermoid carcinoma of the esophagus: a case report. Hum Pathol. 1978;9(3):352–4.

    Article  PubMed  CAS  Google Scholar 

  26. Bell-Thomson J, Haggitt RC, Ellis FH Jr. Mucoepidermoid and adenoid cystic carcinomas of the esophagus. J Thorac Cardiovasc Surg. 1980;79(3):438–46.

    PubMed  CAS  Google Scholar 

  27. Kormano MJ, Yrjana J. Radiology of uncommon esophageal neoplasms. Eur J Radiol. 1981;1(1):51–2.

    PubMed  CAS  Google Scholar 

  28. Lin YK, Wang LS, Fahn HJ, Tu CW, Wu YC, Huang MH. Primary uncommon malignant tumors of the esophagus: an analysis of 30 cases. Zhonghua Yi Xue Za Zhi (Taipei). 1995;55(6):463–71.

    PubMed  CAS  Google Scholar 

  29. Turkyilmaz A, Eroglu A, Gursan N. Muco-epidermoid carcinoma of the oesophagus: a case report. Acta Chir Belg. 2009;109(3):416–8.

    PubMed  CAS  Google Scholar 

  30. Batoon SB, Banzuela M, Angeles HG, Zoneraich S, Maniego W, Co J. Primary mucoepidermoid carcinoma of the esophagus misclassified as adenocarcinoma on endoscopic biopsy. Am J Gastroenterol. 2000;95(10):2998–9.

    Article  PubMed  CAS  Google Scholar 

  31. Pascal RR, Clearfield HR. Mucoepidermoid (adenosquamous) carcinoma arising in Barrett’s esophagus. Dig Dis Sci. 1987;32(4):428–32.

    Article  PubMed  CAS  Google Scholar 

  32. Lam KY, Loke SL, Ma LT. Histochemistry of mucin secreting components in mucoepidermoid and adenosquamous carcinoma of the oesophagus. J Clin Pathol. 1993;46(11):1011–5.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  33. Fegelman E, Law SY, Fok M, Lam KY, Loke SL, Ma LT, et al. Squamous cell carcinoma of the esophagus with mucin-secreting component. Mucoepidermoid carcinoma. J Thorac Cardiovasc Surg. 1994;107(1):62–7.

    PubMed  CAS  Google Scholar 

  34. Hagiwara N, Tajiri T, Miyashita M, Sasajima K, Makino H, et al. Biological behavior of mucoepidermoid carcinoma of the esophagus. J Nippon Med Sch. 2003;70(5):401–7.

    Article  PubMed  Google Scholar 

  35. Mafune K, Takubo K, Tanaka Y, Fujita K. Sclerosing mucoepidermoid carcinoma of the esophagus with intraepithelial carcinoma or dysplastic epithelium. J Surg Oncol. 1995;58(3):184–90 Review.

    Article  PubMed  CAS  Google Scholar 

  36. Kuwano H, Ueo H, Sugimachi K, Inokuchi K, Toyoshima S, Enjoji M. Glandular or mucus-secreting components in squamous cell carcinoma of the esophagus. Cancer. 1985;56(3):514–8.

    Article  PubMed  CAS  Google Scholar 

  37. Stout AP, Latters RL. Tumor of the esophagus. Atlas of tumor pathology, Fsa 20. Washington: AFIP; 1957. p. 72–6.

    Google Scholar 

  38. Dodge OG. Gastro-oesophageal carcinoma of mixed histological type. J Pathol Bacteriol. 1961;81:459–71.

    Article  PubMed  CAS  Google Scholar 

  39. Mafune K. Histochemical study of adenocarcinomatous components in carcinoma of the esophagus. J Jpn Surg Soc. 1988;89(2):162–72 (Japanese with English abstract).

    CAS  Google Scholar 

  40. Nakaya H, Ohkuta Y, Kitano N, Matsushita I, Nagahama T, Kudo T, et al. 0-IIc type of early esophageal cancer, minute mucoepidermoid carcinoma histologically found in squamous cell carcinoma, report of a case. Stomach Intest. 1996;31(10):1279–85 (Japanese with English abstract).

    Google Scholar 

  41. Okuyama T, Adachi K, Ueki K, Kinoshita Y. A case of esophageal mucoepidermoid carcinoma diagnosed and treated by endoscopic mucosal resection. Gastroenterol Endosc. 2000;42(1):14–9 (Japanese with English abstract).

    Google Scholar 

  42. Kanazawa N, Nakata Y, Kubota A, Mori Y, Terauchi K, Ichii S. A case of esophageal mucoepidermoid carcinoma- histopathological comparison with normal esophageal tissue. Acta Med Hyogo. 1989;14:195–210 (Japanese with English abstract).

    Google Scholar 

  43. Motojima T, Nabeya K, Fukuzumi N. A case of esophageal collision tumor with multicentric mucoepidermoid carcinoma and squamous cell carcinoma. J Kyorin Med Soc. 1985;16(3):397–404 (Japanese with English abstract).

    Google Scholar 

  44. Yamamoto N, Watabiki Y, Kosaka A. A case of primary esophageal mucoepidermoid carcinoma associated with an early gastric carcinoma. J Jpn Surg Assoc. 1998;59(10):2559–63 (Japanese with English abstract).

    Article  Google Scholar 

  45. Shibasaki H, Ogata A, Nakamura R, Yoshimura K, Wakabayashi Y, Fukuda H, et al. A case of esophageal mucoepidermoid carcinoma of elderly patient who underwent thoracoscopic subtotal esophagectomy in prone position. Gastroenterol Surg. 2010;33(1):111–7 (Japanese with English abstract).

    Google Scholar 

  46. Tatsuzawa Y, Takehara A, Kinoshita T, Shimizu J, Kawaura Y, Imai M. A case of mucoepidermoid carcinoma of the esophagus. Jpn J Cancer Clin. 2002;48(12):789–94 (Japanese with English abstract).

    Google Scholar 

  47. Masuda T, Tarao H, Konishi N, Shigemori T, Ikeda T, Honzumi M. A case of esophageal mucoepidermoid carcinoma. Geka. 2006;68(4):458–60 (Japanese with English abstract).

    Google Scholar 

  48. Miyashita M, Katsuta M, Nomura T, Makino K, Yamashita S, Takubo K, et al. Mucoepidermoid carcinoma of the esophagus, report of a case. Stomach Intest. 2005;40(3):385–8 (Japanese with English abstract).

    Google Scholar 

  49. Okitsu H, Takechi H, Yamai H, Monden Y. A case of mucoepidermoid carcinoma in the esophagus with early distant metastasis after esophagectomy. J Jpn Surg Assoc. 2001;62(5):1156–61 (Japanese with English abstract).

    Article  Google Scholar 

  50. Hagiwara N, Onda M, Sasajima K, Miyashita M, Okawa K, Matsutani T, et al. Mucoepidermoid carcinoma of the esophagus: a report of two cases. Gastroenterol Endosc. 1998;40(8):1164–71 (Japanese with English abstract).

    Google Scholar 

  51. Yokoo H, Honma M, Hamada K, Nakazato Y. Report of an unoperated autopsy case of mucoepidermoid carcinoma of the esophagus. Pathol Clin Med. 1994;12(4):481–5 (Japanese with English abstract).

    Google Scholar 

  52. Ohno K, Takubo K. Primary mucoepidermoid carcinoma of the esophagus—a case report. J Jpn Soc Clin Cytol. 1989;28(3):420–4 (Japanese with English abstract).

    Article  Google Scholar 

  53. Otagaki S, Takiyama W, Aogi K, Murakami M, Takashima S, Doihara H, et al. A case of early esophageal cancer diagnosed as mucoepidermoid carcinoma. Gastroenterol Surg. 1989;22(11):2677–80 (Japanese with English abstract).

    Article  Google Scholar 

  54. Umegae S, Mori T, Tonouchi H, Kihata T, Yoshino J, Nagata N. A case of primary mucoepidermoid carcinoma of the esophagus. Gastroenterol Surg. 1987;20(9):2201–4 (Japanese with English abstract).

    Article  Google Scholar 

  55. Kumagai Y, Aida J, Ochiai T, Yamazaki S, Kawano T, Takubo K. A case of mucoepidermoid cancer of the esophagus (superficial spreading type). J Jpn Surg Assoc. 2012;73(9):2251–7 (Japanese with English abstract).

    Article  Google Scholar 

  56. Nezu K, Kato H, Tachimori Y, Watanabe H. A clinicopathologic study of 11 adenosquamous carcinoma of the esophagus. Jpn J Gastroenterol Surg. 1991;24(1):1–8.

    Article  Google Scholar 

  57. Kato H, Iizuka T, Watanabe H. Primary adenocarcinoma of the esophagus: report of six cases. Jpn J Clin Oncol. 1980;10(2):301–10.

    Google Scholar 

  58. Matsuki A, Nishimaki T, Suzuki T, Kanda T, Hatakeyama K. Esophageal mucoepidermoid carcinoma containing signet ring cells: three case reports and a literature review. J Surg Oncol. 1999;71(1):54–7.

    Article  PubMed  CAS  Google Scholar 

  59. Stewart FW, Foote FW, Becker WF. Muco-epidermoid tumors of salivary glands. Ann Surg. 1945;122(5):820–4.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  60. The Japan Esophageal Society, editor. Guidelines for clinical and pathologic studies of the esophagus. 7th ed. Tokyo: Kanehara; 1989.

    Google Scholar 

  61. The Japan Esophageal Society, editor. Guidelines for clinical and pathologic studies of the esophagus. 8th ed. Tokyo: Kanehara; 1992.

    Google Scholar 

  62. Merkow RP, Bilimoria KY, McCarter MD, Chow WB, Gordon HS, Stewart AK, et al. Effect of histologic subtype on treatment and outcomes for esophageal cancer in the United States. Cancer. 2012;118(13):3268–76.

    Article  PubMed  Google Scholar 

  63. Igaki H, Ando N, Shinoda M, Shimizu H, Nakamura T, Ozawa S et al. A randomized trial of postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). J Clin Oncol. 2008;26(Suppl):Abstract 4510.

  64. Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74.

    Article  PubMed  Google Scholar 

  65. Ando N, Iizuka T, Ide H, Ishida K, Shinoda M, Nishimaki T, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study—JCOG 9204. J Clin Oncol. 2003;21(24):4592–6.

    Article  PubMed  Google Scholar 

  66. Morita M, Yoshida R, Ikeda K, Egashira A, Oki E, Sadanaga N, et al. Advances in esophageal cancer surgery in Japan: an analysis of 1000 consecutive patients treated at a single institute. Surgery. 2008;143(4):499–508.

    Article  PubMed  Google Scholar 

  67. Hidaka H, Hotokezaka M, Nakashima S, Uchiyama S, Maehara N, Chijiiwa K. Sex difference in survival of patients treated by surgical resection for esophageal cancer. World J Surg. 2007;31(10):1982–7.

    Article  PubMed  Google Scholar 

  68. Nozoe T, Oyama T, Takenoyama M, Hanagiri T, Sugio K, Yasumoto K. Significance of immunohistochemical expression of estrogen receptors alpha and beta in squamous cell carcinoma of the esophagus. Clin Cancer Res. 2007;13(14):4046–50.

    Article  PubMed  CAS  Google Scholar 

  69. Utsumi Y, Nakamura T, Nagasue N, Kubota H, Morikawa S. Role of estrogen receptors in the growth of human esophageal carcinoma. Cancer. 1989;64(1):88–93.

    Article  PubMed  CAS  Google Scholar 

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Kumagai, Y., Ishiguro, T., Kuwabara, K. et al. Primary mucoepidermoid carcinoma of the esophagus: review of the literature. Esophagus 11, 81–88 (2014). https://doi.org/10.1007/s10388-014-0414-z

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