Basaloid squamous cell carcinoma is a well-established anatomopathologic entity of the upper aerodigestive tract and is more aggressive than the conventional squamous cell carcinoma. Only seven cases of this variant have been reported in the esophagus. Two cases of basaloid squamous carcinoma in the middle and lower third of the esophagus in two men aged 59 and 60 years are presented. Tumor stages were IIA and IV at the time of total esophagectomy, and survival times were 34 and 4 months, respectively. Histologically, the two tumors were composed of nests of cells with a basaloid appearance, the first with a predominantly cribriform pattern and the second with a solid lobular pattern and intense comedonecrosis; in the adjacent squamous epithelium of both tumors, carcinoma in situ was observed focally. Immunoreactivity was poor for high-molecular-weight cytokeratins and absent for those of low molecular weight. Staining for epithelial membrane antigen was weakly positive, enolase was moderately positive, and no reactivity for carcinoembryonic antigen, S100 protein, and chromogranin was observed. The flow cytometric analysis showed both tumors to be hyperdiploid with an index of cell proliferation of over 50%.
Flow cytometric DNA analysis is useful in detecting multiple genetic alterations in squamous cell carcinoma of the esophagus
