Carcinoma of the oesophagus with spindle cell features

In the present review we have collected 127 carcinosarcomas and 56 pseudosarcomas of the esophagus from the literature. There were no significant differences in age, sex, symptoms, location, or stalk involvement between the two groups. Infiltrative lesions were observed in 7.5% and 4.0%, respectively. The rate of lymph node metastasis was 52.5% for carcinosarcoma and 45.0% for pseudosarcoma. The resectability was similar in the two groups, and the recurrence rates were 38.0% and 45.5%, respectively. Although recent immunohistochemical and electron microscopic studies suggested that carcinosarcoma and pseudosarcoma are a single pathologic entity of epithelial origin, no one has ever compared the clinical behavior of the two entities. Our study showed that the two neoplasms have similar clinical and behavioral outcomes. These findings support, once more, the unifying theory; and we suggest that the definition of "polypoid spindle cell carcinoma of the esophagus" be adopted.

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“…Other authors, such as Takubo et al [20], Du Boulay and Isaacson [30], and Itabashi et al [42] supported this hypothesis.…”

Section: Discussionmentioning

confidence: 85%

Carcinosarcoma and Pseudosarcoma of the Esophagus: Two Names, One Disease—Comprehensive Review of the Literature

Iascone

Barreca

1999

World j. surg.

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“…10 Indeed, it has been suggested that by preventing fixation to the host tissue, failure to induce a desmoplastic stromal reaction by sarcomatous cells may play a role in the development of polypoid configuration. 15 Despite the rapid growth of carcinosarcoma, many papers refer to a good prognosis; however, according to Iyomasa et al, 6 the prognosis is not as favorable as previously believed due to the high possibility of hematogenous metastasis in the late period. They emphasized that radical resection with lymph node dissection was necessary to treat carcinosarcomas regardless of the depth of invasion.…”

Section: Discussionmentioning

confidence: 99%

Rapid-Growing Carcinosarcoma of the Esophagus Arising from Intraepithelial Squamous Cell Carcinoma: Report of a Case

Uchiyama¹,

Imai²,

Hoshino³

et al. 2000

Surg Today

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A case of carcinosarcoma arising from the intraepithelial spreading area of esophageal squamous cell carcinoma (SCC) is reported herein. A 64-year-old man was referred to our hospital for investigation of a sore throat and dysphagia. An endoscopic examination revealed a 2. 5-cm polypoid mass in the mid-esophagus. Esophagograms taken 1 month prior to consultation by our hospital and just before surgery revealed marked change within a period of less than 2 months from a 2-cm sessile elevated mass to a 4-cm polypoid mass with a lobular appearance. The resected specimen contained two lesions in the esophagus. The larger one measured 4.0 x 2.0 x 2.0 cm and had a pedunculated polypoid shape, while the smaller one, measuring 1 cm in diameter, was a plateau-type elevated lesion located 3 cm distal from the larger mass. Histologically, the distal smaller lesion was diagnosed as primary SCC associated with a high frequency of intraepithelial spread, while the larger polypoid mass was composed of spindle-shaped sarcomatous cells, arising from the intraepithelial spread of SCC. To our knowledge, this is the only reported case of esophageal carcinosarcoma arising from an area of intraepithelial spread of SCC that showed such surprisingly rapid growth.

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“…The risk of nodal metastasis increases with the depth of invasion and rises dramatically once tumours have penetrated the submucosa. Occasionally an adenocarcinomatous [154], adenocystic [155], neuro-endocrine or glandular component may be present [156]. Skip metastases may be present in oesophageal cancers and distant metastases to the lungs and liver have been reported in up to 50% of all squamous cell carcinomas [141].…”

Section: Deep Oesophageal Cancermentioning

confidence: 99%