Carcinosarcoma of the Thoracic Esophagus That Presented as Focal Ulcerative Lesion

Esophageal carcinosarcoma is a rare malignant tumor composed of both carcinomatous and sarcomatous elements. We report a case of esophageal carcinosarcoma in a 56-year-old woman with dysphagia. Esophageal ulcerative tumors were detected by endoscopy and resected by thoracoscopic esophagectomy. Carcinosarcoma was confirmed by the presence of both carcinomatous and sarcomatous tumor components. On immunohistochemistry, the sarcomatous area was positive for keratin staining, while the sarcomatous area was positive for vimentin staining. The tumor reportedly had a better prognosis than SCC of the esophagus, especially in terms of survival rate. The patient’s disease was classified as ypT3N0M0, ypStage II. No definitive diagnosis was made preoperatively. We report this case along with a review of the literature.

Esophageal Carcinosarcoma Comprising of Undifferentiated Pleomorphic Sarcoma and Squamous Cell Carcinoma: A Case Report

Introduction: Esophageal carcinosarcoma (ECS) is a rare malignant tumor that often presents as an intraluminal polypoid lesion in the esophageal lumen. Herein we present a case diagnosed as esophageal carcinosarcoma and treated with esophagectomy.Case presentation: A 68-year-old male patient was presented to the thoracic surgery department complaining of dysphagia for about three months. He was diagnosed with ECS and underwent uniport video-assisted thoracic surgery (VATS). Based on the histopathological reports, the patient was finally diagnosed as ECS, clinical T1bN0M0, pathological stage I. 11 days after the surgery, the patient was discharged from the hospital without experiencing any complications.Conclusion: Carcinosarcoma was first described by Virchow in 1865 as a rare malignant neoplasm. The clinical manifestations of ECS includes dysphagia, chest pain and weight loss. IHC analysis indicates carcinoma and the sarcoma occurred independently. Complete resection of the esophagus with lymphadenectomy of locoregional nodes is still recommended as the best potentially curative treatment. For the prognosis of ECS compared to (ESCC), there is a controversy. Here, we reported a case of ECS comprising of squamous cell carcinoma in situ and undifferentiated pleomorphic sarcoma underwent uniport VATS esophagectomy with no serious complications, which indicate that VATS esophagectomy could be applied to ECS patients.

Esophageal Carcinosarcoma: Analysis of Clinical Features and Prognosis of 24 Cases and a Literature Review

Objective: Esophageal carcinosarcoma (ECS) is a rare malignant tumor that accounts for only 0.5%-2.8% of all esophageal malignancies. As most current studies are case reports, the relationship between clinical features and prognosis remains controversial. Methods: We investigated the clinical features and prognosis of 24 patients with ECS in a single center from 2006 to 2018. There were 18 male and 6 female patients aged 52-82 years with a median age of 62.5 years. In addition, we included 9 studies on ECS from PubMed and a literature review. Results: The median follow-up time of the 24 patients was 70.5 (range, 10-156)months. The 3-year and 5-year survival rates were 83.3% and 70.8%, respectively. Among the 24 patients, none of the 10 (41.7%) stage T1 cancer patients had lymph node metastasis; however, lymph node metastasis was noted in 8 (57.1%) stage T2-4 cancer patients. The literature review revealed that 211 patients had a 5-year survival rate of 11.8%-68.2%, and 54.5%-95.8% study participants had early stage ECS. Although the information provided in the literature review is limited, it appears to be a characteristic of the early stage of the disease and predicts better prognosis when ECS is diagnosed, which is similar to the result of the current study. Conclusion: Our results indicate that ECS has a favorable prognosis, even among patients with early stage ECS who undergo radical esophagectomy with lymph node dissection. Because of the low incidence of ECS, further studies with more cases need to investigate this rare malignancy.

Esophageal Carcinosarcoma in a Patient with Corrosive Esophagitis

Esophageal carcinosarcoma is a rare type of esophageal cancer characterized by both carcinomatous and sarcomatous components. Its endophytic growth tendency into the esophageal lumen leads to a higher curative resection rate. However, lymph node metastases in esophageal carcinosarcoma occur at a relatively early stage. We report a case of esophageal carcinosarcoma in a 52-year-old man who had dysphagia for 2 months and a history of ingestion of glacial acetic acid in adolescence. His endoscopy and chest CT results showed an 8.5-cm-sized ulcerative polypoid mass with multiple lymph node metastases in the mid-esophagus. Biopsy revealed an interweaving spindle cell proliferation with squamous dysplasia. Immunohistochemical staining showed positive expressions of vimentin and cytokeratin. Even though the patient received concomitant chemoradiotherapy with a stent insertion, he died 7 months after diagnosis. We herein present a case of corrosive esophagitis followed by esophageal carcinosarcoma that suggested the possibility of an association between the two diseases.