TY - JOUR
T1 - Multiple carcinosarcomas of the esophagus with adeno-carcinomatous components
T2 - A case report
AU - Okamoto, Hiroshi
AU - Kikuchi, Hiroshi
AU - Naganuma, Hiroshi
AU - Kamei, Takashi
N1 - Publisher Copyright:
© The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
PY - 2020/5/7
Y1 - 2020/5/7
N2 - BACKGROUND Carcinosarcoma (spindle cell carcinoma) of the esophagus is an extremely rare event; the etiology and origins of this neoplasm have not yet been determined. Epithelial-mesenchymal transition (EMT) has been associated with invasion and metastasis, and may be related to the generation of a stem cell population within this tumor. CASE SUMMARY We present the case of a 61-year-old male with nausea and fever. Upper gastrointestinal endoscopy revealed the presence of type 1 and 0-IIc lesions located 35 cm from the incisors toward the esophago-gastric junction. Thoracoscopic esophagectomy was performed. Macroscopic analysis revealed three polypoid lesions in the abdominal esophagus that accompanied the main lesion in the lower thoracic esophagus and 0-IIc lesions that spread continuously with them. Histologically, the lesions included proliferating spindle cells. Adeno-carcinomatous components were detected in a section near the foot, and squamous cell carcinoma was identified in the mucosa at the base of the tumor. The patient was diagnosed with multiple carcinosarcomas, staged at pT1b (SM3), pN1 (#110, #7), cM0, Stage II (sarcomatous metastasis to the lymph nodes). Spindle cells did not express E-cadherin but were positive for EMT markers, including zinc finger E-box-binding homeobox 1, TWIST, and snail family transcriptional repressor 2. The patient has experienced no recurrence at 5 years and 2 mo after surgery. CONCLUSION This report suggests that multiple sarcomatous tumors may be generated from primary squamous cell carcinoma via mechanisms related to EMT.
AB - BACKGROUND Carcinosarcoma (spindle cell carcinoma) of the esophagus is an extremely rare event; the etiology and origins of this neoplasm have not yet been determined. Epithelial-mesenchymal transition (EMT) has been associated with invasion and metastasis, and may be related to the generation of a stem cell population within this tumor. CASE SUMMARY We present the case of a 61-year-old male with nausea and fever. Upper gastrointestinal endoscopy revealed the presence of type 1 and 0-IIc lesions located 35 cm from the incisors toward the esophago-gastric junction. Thoracoscopic esophagectomy was performed. Macroscopic analysis revealed three polypoid lesions in the abdominal esophagus that accompanied the main lesion in the lower thoracic esophagus and 0-IIc lesions that spread continuously with them. Histologically, the lesions included proliferating spindle cells. Adeno-carcinomatous components were detected in a section near the foot, and squamous cell carcinoma was identified in the mucosa at the base of the tumor. The patient was diagnosed with multiple carcinosarcomas, staged at pT1b (SM3), pN1 (#110, #7), cM0, Stage II (sarcomatous metastasis to the lymph nodes). Spindle cells did not express E-cadherin but were positive for EMT markers, including zinc finger E-box-binding homeobox 1, TWIST, and snail family transcriptional repressor 2. The patient has experienced no recurrence at 5 years and 2 mo after surgery. CONCLUSION This report suggests that multiple sarcomatous tumors may be generated from primary squamous cell carcinoma via mechanisms related to EMT.
KW - Case report
KW - Epithelial-mesenchymal transition
KW - Epithelial-mesenchymal transition markers
KW - Esophagus
KW - Multiple carcinosarcomas
KW - Multiple spindle cell carcinomas
UR - http://www.scopus.com/inward/record.url?scp=85086625106&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086625106&partnerID=8YFLogxK
U2 - 10.3748/WJG.V26.I17.2111
DO - 10.3748/WJG.V26.I17.2111
M3 - Article
C2 - 32536778
AN - SCOPUS:85086625106
VL - 26
SP - 2111
EP - 2118
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 17
ER -