A Primary Barrett's Adenocarcinoma with a Squamous Cell Carcinoma Component

Abstract

The present report describes an extremely rare case of Barrett's adenocarcinoma (BAC) with a squamous cell carcinoma (SCC) component. A 55-year-old man was diagnosed with esophageal adenocarcinoma on Barrett's esophagus. The patient underwent endoscopic submucosal dissection, but the pathology revealed deep submucosal invasive, moderately differentiated tubular adenocarcinoma and focal SCC with vascular invasion. In addition, morphological transition between adenocarcinoma and SCC components was confirmed. The patient underwent additional surgery, which revealed lymph node metastasis, and then received S-1 adjuvant chemotherapy. Based on the pathological findings, the transdifferentiation process may have a role in the histogenesis of this tumor.

c-FOS drives reversible basal to squamous cell carcinoma transition

“…Because of the occurrence of squamous transdifferentiation in many adenocarcinomas ( Hou et al, 2016 ; Kay, 1968 ; Lee, 2019 ; Madura et al, 1999 ; Mori et al, 1987 ; Nakagawa et al, 2003 ; Rahemtullah et al, 2003 ; Shundo et al, 2011 ; Takeuchi et al, 2019 ; Tan et al, 2017 ) and its particular relevance to BCC resistance and aggressiveness ( Kuonen et al, 2019 ; Zhao et al, 2015 ), we sought to identify the transcriptional reprogramming underlying BST. We first built bulk transcriptomic signatures for BCC and SCC based on the differential gene expression analysis between human BCCs ( Bonilla et al, 2016 ) and SCCs ( Chitsazzadeh et al, 2016 ) ( Figures S1A and S1B ; Table S1 ).…”

“…Efforts at early detection, precise identification of tumor type, and clear understanding of initial cancer sensitivities fail as tumors toggle between cellular identities, resulting in relapse and recurrence ( Boumahdi and de Sauvage, 2020 ; Shen et al, 2020 ). Basal-to-squamous carcinoma transdifferentiation is a common epithelial tumor lineage reprogramming, occurring spontaneously or upon targeted therapy in adenocarcinomas of the lung ( Hou et al, 2016 ; Nakagawa et al, 2003 ; Shundo et al, 2011 ), stomach ( Mori et al, 1987 ), esophagus ( Kay, 1968 ; Takeuchi et al, 2019 ), pancreas ( Madura et al, 1999 ; Rahemtullah et al, 2003 ), prostate ( Lee, 2019 ), and skin ( Tan et al, 2017 ). Poor patient outcomes associated with these alterations in tumor cell identity and sensitivities present clear unmet clinical needs, requiring further mechanistic understanding ( Boumahdi and de Sauvage, 2020 ; Shen et al, 2020 ).…”

Two Cancers in One Barrett’s Segment: First Report of Concurrent Squamous Cell Carcinoma and Adenocarcinoma

“…Barrett´s esophagus is a well-acknowledged risk factor for esophageal AC formation; however, singular cases of SCC arising in Barrett's esophagus and/or collision tumor comprising SCC and AC elements have been documented in the literature, pointing to ambivalent carcinogenic field effects [ 1 , 2 , 3 ]. Concurrent SCC and Barrett's carcinoma has occasionally been reported in Barrett's esophagus before, however, to the best of our knowledge, not with the Barrett's segment itself [ 4 , 5 , 6 ].…”