Adenosquamous carcinoma of the esophagus after endoscopic variceal sclerotherapy: a case report and review of the literature

Sakata, Kumiko; Ishida, Motoo; Hiraishi, Hideyuki; Sasai, Takako; Watanabe, Naomi; Suzuki, Yasunaga; Masuyama, Hironori; Terano, Akira

doi:10.1016/s0016-5107(98)70330-x

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…Although several case reports on ASC of the esophagus are available, the incidence and clinicopathological characteristics of ASC have not been fully characterized yet in large‐scale series analyses in a single institution because of the lower incidence rate of this disease . The frequency of esophageal ASC accounted for approximately 0.5–1% of all esophageal carcinomas in most series . In our study, 24 (0.37%) of 6546 esophageal carcinoma cases were pathologically confirmed as ASC, which was lower than previous studies.…”

Section: Discussioncontrasting

confidence: 69%

“…It has been suggested to have developed initially as SCC, and then into ASC as a result of a subsequent occurrence of glandular metaplasia, or may also have been primarily an adenocarcinoma with areas of squamous metaplasia in tumor cell differentiation . Some authors infer the collision concept, which hypothesizes that two individual stem cells may have simultaneously and independently undergo malignant transformation . However, some authors posited that the tumor may also have arisen from the mucous epithelium of a Barrett's esophagus …”

Section: Discussionmentioning

confidence: 99%

“…Esophageal adenosquamous carcinoma (ASC) is a rare malignancy which is histologically characterized by having both AC and SCC within the same tumor . Most studies on this disease are mostly limited to case reports or small‐scale case series involving a handful of cases . Data evaluating the biological behavior and clinicopathological features of esophageal ASC are few because of the rarity of this disease.…”

Section: Introductionmentioning

confidence: 99%

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Primary esophageal adenosquamous carcinoma: a retrospective analysis of 24 cases

et al. 2013

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Primary adenosquamous carcinoma (ASC) of the esophagus is a rare kind of malignancy characterized by mixed glandular and squamous differentiation as well as a propensity for aggressive clinical behavior. Data on the evaluation of the clinicopathological features and the prognosis of patients suffering from this malignancy are few because of the rarity of this disease. We conducted a retrospective review of 24 patients with primary esophageal ASC among 6546 esophageal cancer patients who underwent transthoracic esophagectomy in our hospital. The clinicopathological presentation, diagnosis, treatment, and prognostic factors of the patients were respectively investigated. The Kaplan-Meier method and the log rank test were used to calculate and compare overall survival (OS). The Cox proportional hazards model was employed to identify independent prognostic factors. There were 18 males and 6 females with a median age of 60 years (range: 40-78 years). The clinical symptoms, macroscopic type, as well as the radiological and endoscopic features of esophageal ASC were similar to those of esophageal squamous cell carcinoma. Sixteen (88.9%) of the 18 cases who underwent preoperative esophagoscopic biopsy were misdiagnosed as adenocarcinoma or squamous cell carcinoma. The overall median follow-up period was 36 months, and the median survival time was 32 months. The 1, 3, 5-year OS rates were 75.0%, 48.5%, and 19.4%, respectively. Univariate analysis showed that gender (P=0.047), lymph node metastasis (P=0.007), and TNM stage (P=0.037) were important factors associated with OS of the 22 patients who underwent radical resection. Multivariate analysis showed that the pathological N stage was the only independent prognostic factor (P=0.031, hazard ratio [HR], 5.369, 95% confidence interval [CI], 1.167-24.700). These results suggest that esophageal ASC is an uncommon disease prone to be misdiagnosed by endoscopic biopsy. Surgical resection is the primary treatment, but the prognosis of ASC is usually poorer than conventional squamous cell carcinoma. Lymph node metastasis is an independent prognostic factor after radical resection.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary esophageal adenosquamous carcinoma: a retrospective analysis of 24 cases

et al. 2013

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“…ASC can also be misdiagnosed as mucoepidermoid carcinoma, another rare tumor that features both squamous cells and a prominent mucin-secreting component [19] . While ASC and mucoepidermoid carcinoma have often been referred to interchangeably in the literature [20,21] , they are histologically distinct tumors.…”

Section: Discussionmentioning

confidence: 99%

Adenosquamous Carcinoma of the Esophagus: An NCDB-Based Investigation on Comparative Features and Overall Survival in a Rare Tumor

et al. 2017

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Objectives: Esophageal adenosquamous carcinoma (ASC) is a rare tumor with characteristics of adenocarcinoma (AC) and squamous cell carcinoma (SCC), the two most common esophageal cancers. Its behavior is aggressive but poorly understood. Using the National Cancer Database (NCDB), the clinical features and overall survival of ASC were compared with AC and SCC. Methods: The NCDB was queried for patients with esophageal ASC, AC, and SCC. Univariate association of histology with patient characteristics and overall survival were analyzed and socioeconomic characteristics were balanced. Results: Clinical M stage was 0 in a significantly lower proportion of ASC (69.0%) than in AC (70.9%) or SCC (75.6%) (p < 0.001). Median survival was lower in patients with ASC (9.6 months) than with AC (13.5) or SCC (9.7) and 2-year OS was lower in patients with ASC (23.8%) than with AC (34.6%) or SCC (26.5%) (p < 0.001). The OS hazard ratio for ASC was 1.14 when compared to AC (95% CI = 1.016-1.267, p = 0.025) and 1.10 when compared to SCC, but the latter was not significant (95% CI = 0.980-1.222, p = 0.111). Conclusion: ASC is a rare tumor among esophageal carcinomas with a greater burden of metastatic disease than AC or SCC and worse OS than AC.

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“…Most descriptions of this variant of esophageal cancer consist of case reports or small case series (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). While most reports from the western world are single cases, recently small case series have been reported from China and Japan (14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of adenosquamous esophageal carcinoma

Yendamuri¹,

Malhotra²,

Hennon³

et al. 2017

J. Gastrointest. Oncol.

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Background: Current published information of adenosquamous carcinoma (ASC) of the esophagus in the United States is limited to isolated case reports. We sought to study the clinical characteristics of this tumor using the Surveillance, Epidemiology and End Results (SEER) database.Methods: Relevant data of all patients with esophageal cancer in the SEER database diagnosed from 1998-2010 was obtained. Demographic, grade, stage, treatment and survival characteristics of patients with ASC were summarized and compared to those patients with adenocarcinoma (ACA) and squamous cell carcinoma (SqCC). Univariate analyses across comparison groups were performed using Wilcoxon rank sum test for continuous covariates and the Pearson Chi-square test for categorical covariates. To evaluate the association of selected covariates to survival by histology, unadjusted and adjusted proportional hazards models were generated for the entire study population. To further control for the difference in covariates among the histology groups, propensity weighted Cox regression modeling was performed using the inverse propensity to treat weighting (IPTW) approach. Conclusions: ASC of the esophagus is a rare histological variant comprising 1% of esophageal ACA in the Unites States. This histological subtype presents in later stages, at a higher grade and portends a poorer survival than the more common ACA. Radiation therapy and surgical resection of appropriate stage patients provide the best chance of survival.

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Adenosquamous carcinoma of the esophagus after endoscopic variceal sclerotherapy: a case report and review of the literature

Cited by 14 publications

References 18 publications

Primary esophageal adenosquamous carcinoma: a retrospective analysis of 24 cases

Primary esophageal adenosquamous carcinoma: a retrospective analysis of 24 cases

Adenosquamous Carcinoma of the Esophagus: An NCDB-Based Investigation on Comparative Features and Overall Survival in a Rare Tumor

Clinical characteristics of adenosquamous esophageal carcinoma

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