A case of rapidly progressing leiomyosarcoma combined with squamous cell carcinoma in the esophagus

Abstract

Esophageal leiomyosarcoma is a rare tumor that accounts for less than 1% of all malignant esophageal tumors. Esophageal leiomyosarcoma combined with squamous cell carcinoma is even rarer than solitary leiomyosarcoma. We experienced a case of leiomyosarcoma combined with squamous cell carcinoma that progressed very rapidly.

Kissing tumors; the concurrent diagnosis of leiomyosarcoma and squamous cell carcinoma of the esophagus

“…It is estimated that esophageal LMS accounts for about 0.5% of esophageal carcinomas [ 3 ]. Esophageal LMS concurrent with carcinoma is even rarer [ 6 , 9 , 11 – 16 ]. The summary of such cases is presented in Table 1 .…”

“…To our knowledge, there are only eight cases of simultaneous LMS and SCC, of which three cases were in the esophagus [ 6 , 15 , 16 ]. In a study by Jang et al [ 6 ], a 72-year-old male patient presenting with chest pain was diagnosed with polypoid LMS in mid esophagus combined with SCC, similar to our case. However, the diagnostic method and tumor progression differed, as they reported a rapidly growing LMS, although LMS is generally considered a tumor with a slow growth rate [ 17 ].…”

“…In our case, several modalities such as ultrasound, endoscopy, and FNA could not result in a definitive diagnosis, and we had to perform exploratory surgery for resection of the organs suspected of tumor involvement. Jang and colleagues suggested using the Positron emission tomography/computed tomography scan as a useful tool in diagnosing esophageal LMS [ 6 ]. Nakao et al[ 7 ] also performed IHC examination that showed positive SMA and vimentin and negative CK and S100, which is similar to the present study showing positive results for SMA and Ki67 expression in LMS.…”

“…There are few case reports of esophageal LMS [ 4 , 5 ]. There are even fewer cases reporting esophageal LMS with SCC, occurring/diagnosed simultaneously [ 6 ], or after esophageal SCC [ 7 ]. Some have also reported LMS and SCC's simultaneous incidence in the larynx [ 8 ] and oral cavity [ 9 ].…”

A case of esophageal granular cell tumor diagnosed by mucosal incision-assisted biopsy

“…However, there were other possibilities in this case [ 11 ]. If it was a malignant submucosal tumor such as gastrointestinal stromal tumor (GIST) and leiomyosarcoma which might also present with low echoic aspect in EUS and increased FDG uptake in PET-CT [ 12 , 13 ], it must be resected surgically apart from lymphoma. We also supposed the tumor to be GCT, which was possible to remove endoscopically, because it was yellowish and low echoic, even if it was atypical due to the increased FDG uptake.…”