Verrucous Carcinoma of the Esophagus: A Potential Diagnostic Dilemma

Ahmed, Khondoker Shahin; Timmerman, Gary; Meyer, R.A.; Miller, Tara; Mazurczak, Miroslaw; Tams, Kimberlee C.; Atiq, Muslim

doi:10.1159/000357303

Cited by 16 publications

(16 citation statements)

References 10 publications

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“…Previous reports have shown a sensitivity of only 46% for diagnosing verrucous carcinoma on superficial biopsies 6. This makes diagnosis challenging requiring repeat procedures with multiple biopsies using large capacity forceps or even complete resection for histopathology 11–14. In our patient as well, we were able to confirm diagnosis only after EMR was performed and deeper tissue examination was possible by an expert pathologist.…”

Section: Discussionmentioning

confidence: 60%

Experience with endoscopic resection of oesophageal verrucous carcinoma and literature review

Soota

Tirumanisetty²,

Lee

et al. 2019

BMJ Case Rep

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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.

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Section: Discussionmentioning

confidence: 60%

Experience with endoscopic resection of oesophageal verrucous carcinoma and literature review

Soota

Tirumanisetty²,

Lee

et al. 2019

BMJ Case Rep

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“…In most reported cases of verrucous carcinoma, multiple biopsies were performed before a definitive diagnosis was rendered. 38,40,47 Interestingly, coexisting fungal infection was discovered in a couple of cases. 48,49 Verrucous carcinoma should be differentiated from benign lesions, such as papilloma and low-grade squamous dysplasia, which are confined within the epithelium.…”

Section: Squamous Cell Carcinoma Variantsmentioning

confidence: 99%

Squamous Neoplasia in the Esophagus

Savant

Zhang

Yang

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Squamous lesions of the esophagus encompass a spectrum of disorders ranging from reactive changes and benign papilloma to squamous dysplasia and squamous cell carcinoma, which may pose diagnostic challenges especially in superficial biopsies. Objective.— To provide a review on the typical features of squamous neoplasia in the esophagus, with an emphasis on the key diagnostic features as well as differential diagnosis from mimicking lesions. Data Sources.— Data sources include published peer-reviewed literature and personal experiences of the authors. Conclusions.— Accurate diagnosis of squamous neoplasia requires adherence to established diagnostic criteria, attention to subtle histologic features, and correlation with clinical and imaging findings. In difficult cases, multiple biopsies may be necessary to reach a definitive diagnosis.

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“…12 A confirmed diagnosis of esophageal VSCC is usually made by using endoscopic deep biopsies or a resected specimen, because the superficial layer commonly shows a nonspecific inflammatory change and hyperplastic change. 13,14 Esophageal VSCCs are usually occupied by keratinizing squamous epithelium with low-grade minimal cellular atypia in the epithelium, which extends through the pushing infiltration and endophytic papillary growth. 15,16 In addition, VSCC resembles squamous cell papilloma.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent year, concerning suggestive of an advanced VSCC case (T3) obtained by endoscopic ultrasound (EUS), preoperative chemoradiation achieved complete pathological response. 13 Therefore, although it has never before been described concerning the effect of postoperative chemoradioation for advanced esophageal VSCC, combination of postoperative chemoradiation may be a reasonable option.…”

Section: 18mentioning

confidence: 99%

Advanced Verrucous Squamous Cell Carcinoma of the Esophagus: Case Report and Literature Review

Takase

Suzuki

Yamamoto

et al. 2017

International Surgery

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Abstract:Verrucous squamous cell carcinoma (VSCC) is a rare esophageal tumor histologically defined as a well-differentiated subtype. We present a rare case that was diagnosed as esophageal VSCC preoperatively. A 62-year-old Japanese male was referred to our hospital for further evaluation, presenting with anorexia and postcibal vomiting. An esophagogastroduodenoscopy (EGD) examination showed esophageal stricture with white-colored papillary nodules in the lower esophagus. We performed repeated superficial endoscopic biopsies of the lesion, but the histological findings showed nonspecific changes. With an endoscopic boring biopsy, the lesion showed an endophytic growth pattern, well-differentiated SCC with minimal cellular atypia and rare mitosis, and mature squamous epithelium with extensive keratinization. We preoperatively diagnosed the lesion as esophageal VSCC, and we performed a video- Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationassisted thoracoscopic subtotal esophagectomy and cardiectomy with the patient in the prone position. Histological findings revealed that the invasive well-differentiated SCC extended into the esophageal adventitia and the stomach wall with a pushing border. Regional lymph node metastasis and vascular invasion were negative. The expression of Ki-67 was distributed mainly in the basal cells rather than parabasal cells. Without a conclusive diagnosis, a certain degree of diagnostic prediction is possible by understanding the clinical manifestations, macroscopic form and histology around the basal cells. It is helpful to obtain the high accuracy provided by an endoscopic biopsy including the basal layer in order to avoid the diagnostic dilemma that is often presented by esophageal VSCC.

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Verrucous Carcinoma of the Esophagus: A Potential Diagnostic Dilemma

Cited by 16 publications

References 10 publications

Experience with endoscopic resection of oesophageal verrucous carcinoma and literature review

Experience with endoscopic resection of oesophageal verrucous carcinoma and literature review

Squamous Neoplasia in the Esophagus

Advanced Verrucous Squamous Cell Carcinoma of the Esophagus: Case Report and Literature Review

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