576 P40, P63-NEGATIVE NON-SQUAMOUS CELL CARCINOMA OF ESOPHAGUS EXCEPT FOR ADENOCARCINOMA OF ESOPHAGOGASTRIC JUNCTION, REPORT OF TWO CASES

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
F Fujishima ◽  
Y Taniyama ◽  
T Yamauchi ◽  
R Akaishi ◽  
T Kamei ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Squamous Cell ◽  
Esophagogastric Junction ◽  
Resected Specimen ◽  
Thoracic Esophagus ◽  
Tumor Type ◽  
Barrett’S Adenocarcinoma ◽  
Macroscopic Findings

Abstract   Esophageal cancer is the eighth most common human malignancy and the sixth most common cause of death from cancer worldwide. In Europe and the United States, the proportion of adenocarcinoma has increased due to the increase of Barrett's adenocarcinoma. On the other hands, in Japan most cases are squamous cell carcinoma and adenocarcinoma except esophagogstric junction including Barrett's adenocarcinoma is extremely rare. Methods We experienced two cases of tumors with morphologically no distinct squamous or glandular differentiation and confirmed not to be Barrett’s adenocarcinoma. No clear positive findings for p40 and p63 by immunohistochemistry. Case 1 is 69-year-old man. Esophagectomy was performed after neoadjuvant chemotherapy. Macroscopic findings of the resected specimen showed 59 × 43 mm of tumor (type 2) at upper to middle thoracic esophagus. Case 2 is 53-year-old man. Esophagectomy was performed without neoadjuvant chemotherapy. Macroscopic findings of the resected specimen showed 68 × 46 mm of tumor (type 1) at middle thoracic esophagus. Results Pathological examination revealed that the cancer cells showed mainly solid proliferation and no clear keratinization and gland formation was observed. The relationship with the duct of esophageal gland proper was not observed. Immunohistochemistry, tumor cells showed no neuroendocrine differentiation(ChromograninA-, synaptophysin-)and negative for p40, p63 and CK14, on the other hands tumor cells were positive for CK18. Conclusion By the WHO classification, in addition to adenocarcinoma of the esophagogastric junction, squamous cell carcinoma, neuroendocrine tumor, and salivary gland type tumor, there is an item of undifferentiated carcinoma. However, tumor cells of our cases had not such strong atypia, and immunohistochemical study showed glandular differentiation. Although we could not clarify the origin of tumor, it was suggested that there may be carcinoma other than adenocarcinoma of the esophagogastric junction, which may have glandular elements.

scholarly journals Surgically resected primary esophageal choriocarcinoma accompanied with Barrett’s adenocarcinoma: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuta Fujiwara ◽  
Koichi Okamoto ◽  
Itasu Ninomiya ◽  
Hiroto Saito ◽  
Takahisa Yamaguchi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Esophageal Tumor ◽  
Histopathological Diagnosis ◽  
Thoracic Esophagus ◽  
Left Wall ◽  
Barrett’S Adenocarcinoma ◽  
Poorly Differentiated

Abstract Background Choriocarcinomas are usually classified as either gestational or non-gestational. Primary choriocarcinomas in the gastrointestinal tract, especially primary choriocarcinomas in the esophagus, are extremely rare. We report a case of a rare primary esophageal choriocarcinoma mixed with squamous cell carcinoma-like components in association with Barrett’s adenocarcinoma. Case presentation A 58-year-old man visited the hospital, complaining of hematemesis and tarry stools. In emergency upper gastrointestinal endoscopy, a bleeding esophageal tumor was observed. Additionally, a contrast computed tomography (CT) scan showed a large hypervascular tumor 4.8 cm in diameter in the left kidney. He came to our institution for further examination and treatment of the esophageal tumor and kidney lesion. The patient had an easy bleeding elevated tumor 2 cm in diameter at the left wall of the middle thoracic esophagus and a left renal carcinoma. Histopathological diagnosis of the biopsy specimen of the esophageal tumor was a poorly differentiated carcinoma. However, a precise histological type diagnosis could not be obtained. In June 2016, mediastinoscopic transhiatal esophagectomy and posterior mediastinal gastric tube reconstruction were performed to treat his esophageal tumor. Histopathologically, most of the tumor comprised hCG-positive syncytiotrophoblasts. Therefore, we confirmed it as a primary esophageal choriocarcinoma. Furthermore, the tumor contained a poorly differentiated squamous cell carcinoma-like component that was also diagnosed as a choriocarcinoma using immunohistochemical staining and there was a small Barrett’s esophageal adenocarcinoma lesion in the Barrett's epithelium near the tumor. Three months after surgery, a CT scan demonstrated multiple lung metastatic nodules and multiple intrahepatic masses. Needle biopsy from the lung nodule showed a choriocarcinoma. Despite chemotherapy, the metastatic choriocarcinoma regrew rapidly and multiple bone metastases appeared. He died because of his esophageal choriocarcinoma 13 months after primary resection. Conclusions We encountered an extremely rare case of esophageal choriocarcinoma combined with squamous cell carcinoma-like components in association with a simultaneous Barrett’s adenocarcinoma that we followed for the entire course of his disease, from resection to end of life. Esophageal choriocarcinomas are rare with peculiar characteristics and very poor prognoses. Additional cases are needed to establish an appropriate future treatment.

scholarly journals Spindle cell squamous cell carcinoma exhibiting prominent neutrophil phagocytosis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Manabu Yamazaki ◽  
Satoshi Maruyama ◽  
Tatsuya Abé ◽  
Yoshimasa Sumita ◽  
Yuji Katsumi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Squamous Cell ◽  
Spindle Cell ◽  
Cancer Recurrence ◽  
Resected Specimen ◽  
Intense Staining ◽  
Surgical Specimen ◽  
Atypical Cells

Abstract Background Spindle cell squamous cell carcinoma is an uncommon variant of squamous cell carcinoma; its diagnosis is sometimes challenging because it histopathologically resembles neoplastic or reactive spindle cell lesions of mesenchymal origins. Here, we report a rare case of spindle cell squamous cell carcinoma exhibiting prominent neutrophil phagocytosis. Case presentation A 69-year-old Japanese man presented with pain and a polypoid mass on the lower left gingiva. He had received chemoradiotherapy for squamous cell carcinoma of the buccal mucosa 15 years prior to this consultation. In addition, he was treated for mandibular osteonecrosis 6 years after chemoradiotherapy without evidence of cancer recurrence. A biopsy revealed atypical spindle or pleomorphic cells scattered in the edematous and fibrin-rich stroma; however, no malignant squamous components were apparent. These atypical cells frequently contained neutrophils within their cytoplasm that formed cell-in-cell figures. Immunohistochemically, the atypical cells were negative for cytokeratins, epithelial membrane antigen, and E-cadherin, but positive for p63, vimentin, and p53. Although these findings suggested spindle cell squamous cell carcinoma, it was difficult to reach a definitive diagnosis. Based on a clinical diagnosis of a malignant tumor, the patient underwent a hemimandibulectomy. The surgically resected specimen had a typical spindle cell squamous cell carcinoma histology consisting of biphasic spindle cells and conventional squamous cell carcinoma components. Moreover, the surgical specimen also exhibited spindle tumor cells that frequently included neutrophils, around which intense staining for lysosomal-associated membrane protein 1 and cathepsin B was observed. This suggested that the cell-in-cell figures represent active neutrophil phagocytosis by tumor cells, and not emperipolesis. Conclusion The presence of neutrophil phagocytosis may be a potent indicator of malignancy.

PD-L1 and survival in oral cavity squamous cell carcinoma

2020 ◽  
Vol 25 (4) ◽  
pp. 287-294
Author(s):  
S. I. Kutukova ◽  
N. P. Beliak ◽  
G. A. Raskin ◽  
M. S. Mukhina ◽  
Yu. V. Ivaskova ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Squamous Cell ◽  
Immune Cells ◽  
Negative Impact ◽  
Progression Free Survival ◽  
Negative Effect ◽  
Effect Of Pd

Relevance. Prognostic value of PD-L1 expression in oral cavity squamous cell carcinoma (OCSCC) and its effect on survival is still controversial. It should be to determine the prognostic role of PD-L1 expression on tumor and immune cells of OCSCC and assess their effect on overall survival (OS) and progression-free survival (PFS).Materials and methods. A prospective study included 145 patients, first diagnosed with OCSCC. PD-L1 expression on tumor and immune cells, infiltrating tumor and its microenvironment, was assessed in all tumor samples by IHC, CPS was calculated. Cut-off values were determined by ROC analysis for identification of PD-L1 expression effect on OS and PFS.Results. Most patients with oral mucosa squamous cell carcinoma showed positive expression of PD-L1 on tumor (77.2%) and immune cells (92.4%). The median PD-L1 expression on tumor cells was 13.5% [1.0-40.0], the median PD-L1 expression on immune cells was 5.0% [1.0-11.0], and the median CPS – 18.0 [3.0-7.8]. Univariate and multivariate analyses revealed a significant negative effect of PD-L1 expression on immune cells ≤ 7% on OS (HR 0.66; 95% CI 0.45-0.93; p = 0.0498); PD-L1 expression in tumor cells ≤ 15% (HR 0.65; 95% CI 0.43-0.98; p = 0.0416) and CPS ≤ 21 (HR 0.62; 95% CI 0.44-0.92; p = 0.0183) for PFS. PD-L1 expression in tumor cells ≤ 6% (HR 0.71; 95% CI 0.47-1.08; p = 0.1096) and CPS ≤ 7 (RR 0.67; 95% CI 0.44-1.01; p = 0.0575) had a confident tendency to negative impact on OS.Conclusion. Positive PD-L1 expression in tumor and immune cells as well as CPS are effective additional factors in the prognosis of the disease course, OS and PFS in patients with OCSCC.

Time Course of Tumor Metabolic Activity During Chemoradiotherapy of Esophageal Squamous Cell Carcinoma and Response to Treatment

2004 ◽  
Vol 22 (5) ◽  
pp. 900-908 ◽  
Author(s):  
Hinrich A. Wieder ◽  
Björn L.D.M. Brücher ◽  
Frank Zimmermann ◽  
Karen Becker ◽  
Florian Lordick ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Metabolic Activity ◽  
Fdg Pet ◽  
Time Course ◽  
Tumor Response ◽  
Patient Survival ◽  
Resected Specimen

PurposeTo evaluate the time course of therapy-induced changes in tumor glucose use during chemoradiotherapy of esophageal squamous cell carcinoma (ESCC) and to correlate the reduction of metabolic activity with histopathologic tumor response and patient survival.Patients and MethodsThirty-eight patients with histologically proven intrathoracic ESCC (cT3, cN0/+, cM0) scheduled to undergo a 4-week course of preoperative simultaneous chemoradiotherapy followed by esophagectomy were included. Patients underwent positron emission tomography with the glucose analog fluorodeoxyglucose (FDG-PET) before therapy (n = 38), after 2 weeks of initiation of therapy (n = 27), and preoperatively (3 to 4 weeks after chemoradiotherapy; n = 38). Tumor metabolic activity was quantitatively assessed by standardized uptake values (SUVs).ResultsMean tumor FDG uptake before therapy was 9.3 ± 2.8 SUV and decreased to 5.7 ± 1.9 SUV 14 days after initiation of chemoradiotherapy (−38% ± 18%; P < .0001). The preoperative scan showed an additional decrease of metabolic activity to 3.3 ± 1.1 SUV (P < .0001). In histopathologic responders (< 10% viable cells in the resected specimen), the decrease in SUV from baseline to day 14 was 44% ± 15%, whereas it was only 21% ± 14% in nonresponders (P = .0055). Metabolic changes at this time point were also correlated with patient survival (P = .011). In the preoperative scan, tumor metabolic activity had decreased by 70% ± 11% in histopathologic responders and 51% ± 21% in histopathologic nonresponders.ConclusionChanges in tumor metabolic activity after 14 days of preoperative chemoradiotherapy are significantly correlated with tumor response and patient survival. This suggests that FDG-PET might be used to identify nonresponders early during neoadjuvant chemoradiotherapy, allowing for early modifications of the treatment protocol.

Cardiac tamponade as an unusual initial presentation of squamous cell carcinoma of the esophagus

2021 ◽  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Pericardial Effusion ◽  
Cell Carcinoma ◽  
Cardiac Tamponade ◽  
Squamous Cell ◽  
Unknown Etiology ◽  
Thoracic Esophagus ◽  
Moderate Amount ◽  
Carcinoma Of The Esophagus

Pericardial effusions leading to cardiac tamponade have previously been described with esophageal cancer. However, up to eighty percent of these cases have been reported in association with chemotherapy and radiation. Patients with esophageal cancer seldom initially present with pericardial effusion resulting from esophageal pericardial fistula (EPF). Herein, we present the case of a 62-year-old man who presented with pericardial effusion with an unknown etiology at presentation. Subsequently, the patient developed cardiac tamponade and was referred to the tertiary hospital for further evaluation. Computed tomography of the chest revealed a circumferential irregular enhancing lesion at the mid-thoracic esophagus suspecting esophageal cancer with EPF and a moderate amount of pericardial effusion. The patient underwent esophagoscopy and squamous cell carcinoma was found from the esophageal biopsy. An esophageal stent was successfully placed to conceal the perforation. Eventually, the patient died 13 days after admission complicated by refractory septic shock. This case highlights an atypical presentation of esophageal cancer and an unusual cause of cardiac tamponade.

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