A unique case of esophageal carcinosarcoma with histopathological diversities

We report a 57-year-old Japanese male with esophageal carcinosarcoma with histopathological diversities. The patient complained of dysphagia. Endoscopy of the upper gastrointestinal tract revealed a mass in the lower esophagus just above the esophagogastric junction. Pathological diagnosis of the biopsy was poorly differentiated squamous cell carcinoma/undifferentiated carcinoma. Preoperative chemotherapy was performed with poor response. Post-operative analyses revealed that the chest CT showed the appearance of mineralization after neoadjuvant chemotherapy. Surgery revealed a mass in the lower esophagus invading the esophagogastric junction from above. The mass was macroscopically polypoid with an infiltrative ulcer. The pathological diagnosis of the surgical specimen was carcinosarcoma of the lower esophagus, composed of sarcomatoid components (undifferentiated pleomorphic sarcoma-like, osteosarcomatous and chondrosarcomatous), invasive adenocarcinoma with ductal and glandular differentiation, several foci of non-invasive squamous cell carcinoma and invasive conventional and basaloid squamous cell carcinoma (ypT3N0M0, stage II). One year after the operation, the left hilar lymph node enlarged. A biopsy of the lymph node showed adenocarcinoma, consistent with metastatic esophageal cancer. Additional chemotherapy was given. Two years and four months after the operation, the patient died of multiple metastases, these included the brain.
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research