Experience with endoscopic resection of oesophageal verrucous carcinoma and literature review

Abstract

A 65-year-old male patient with chronic dysphagia was found to have a 2 cm mass at gastro-oesophageal junction on endoscopy. Biopsy showed squamous hyperplasia without malignancy. Controlled radial expansion balloon dilatation and partial resection were performed but the symptoms recurred. He finally underwent endoscopic mucosa resection and histology showed well-differentiated verruciform squamous proliferation limited to the mucosa. Small amounts of tumour remnants were treated during subsequent follow-up endoscopies and the patient has been tumour free since then. Diagnosis of oesophageal verrucous carcinoma can be challenging and could be managed with endoscopic resection. In this report, we review the literature and present our experience with a patient with oesophageal verrucous carcinoma.

Verrucous carcinoma of the esophagus – a case report and literature review

“…This finding and the histologically well-differentiated tumor (G1) was the rationale to discuss endoscopic resection of VCE. This appears to be an interesting and effective alternative to surgical resection as shown recently [12]. However, circumferential expression and longitudinal expansion over 5 cm of VCE in our case were the reasons to choose surgical resection.…”

“…VCE is a rare disease, and fewer than 100 cases has been reported in the literature [9][10][11]. We updated the cases with VCE as reported in the literature during the period from 1983 to March 2020 [12][13][14][15]. This literature overview comprised 83 patients, 67 % men and 33 % women, 64 + 9.4 years old.…”

Histomorphology and Molecular Profiling of Well-Differentiated Squamous Cell Carcinoma of the Esophagus Including its Unusual Variants

“…The lesion is commonly described as a white, exophytic, or wartlike mass lesion, hence the name "verrucous". [52][53][54][55][56][57] The lesion is usually localized but can be diffuse and involve the entire esophagus. 58 Unfortunately, VC usually presents at an advanced tumor stage.…”

“…The tumor shows aggressive local invasion; however, distal metastasis has never been reported so far. 54 On endoscopic ultrasound, VC was generally described as an area of localized hypoechoic wall thickening. In some cases, the tumor invasion into the deeper layers of the esophageal wall could also be appreciated.…”

Updates on World Health Organization classification and staging of esophageal tumors: implications for future clinical practice

“…[40] and the tumour could be treated by endoscopic resection in appropriate cases. [41,42] Basaloid squamous carcinoma accounts for 4 to 5% of primary oesophageal carcinoma. [43,44] The carcinoma has carcinoma with basaloid appearance (resemble basal cells in stratified squamous epithelium) with abrupt transition with squamous carcinoma cells.…”