Esophageal carcinoma multiplex with gastric metastasis

We describe here the radiographic findings in a patient with multiple synchronous squamous carcinomas of the esophagus with a large metastasis to the gastric cardia. Radiographic documentation of this constellation of tumor involvement has not previously been reported. The mechanisms of esophageal metastasis are reviewed.     

Esophageal myoepithelial carcinoma: Four case reports

BACKGROUNDMyoepithelial carcinoma (MC) is a rare malignant neoplasm that mainly occurs in the salivary gland. MC can be confused with many other tumors when arising outside the salivary glands because it presents with a wide spectrum of cytomorphological and immunohistochemical features. To the best of our knowledge, esophageal MC has not been previously reported. The purpose of this study was to describe the imaging and clinicopathological features of esophageal MC to improve the understanding of the disease.CASE SUMMARYThree men and one woman diagnosed with esophageal MC were enrolled in this study. The primary clinical symptom was dysphagia. The mass was mainly located in the middle esophagus. Laboratory tests revealed that two patients who underwent tumor abnormal protein were positive. Radical resection was performed for all patients with no adjuvant therapy. Hematoxylin-eosin staining showed infiltrative growth of epithelial cells with hyperchromatic and pleomorphic nuclei toward the periphery. Immunohistochemistry showed that all patients were positive for P63, and most patients were positive for SOX-10, AE1/AE3, P40, and calponin. The Ki-67 values were all higher than 60%. Patient one died one month after discharge from an unknown cause. Patient two lost to follow-up. At patient three’s four-month review, enhanced computed tomography (CT) showed anastomosis recurrence and bilateral lung metastases. He abandoned treatment and lost to follow-up. Patient four attended review appointments regularly and remained in a good general condition.CONCLUSIONHere, we present the first report of esophageal MC and review the relevant literature. Esophageal MC is more likely to occur in the middle esophagus in older patients with male dominance. A fungating type observed on CT scanning may help narrow down the differential diagnosis. Cystic change or necrosis may occur in larger lesions. The final diagnosis should be made according to the pathological examination. The treatment for MC is surgical resection, and the efficacy of chemotherapy needs to be determined with future studies.     

Esophageal squamous cell carcinoma: MRI evaluation of mediastinum

Thirty-two patients with esophageal spinocellular (squamous cell) carcinoma were studied with superconductive magnet in order to evaluate local and extraluminal extent, as well as mediastinal lymph node spread of the disease. In the absence of adenopathy, the localized tumors were considered susceptible to surgical treatment. All patients were operated on within 21 days. The resectability criteria were correctly evaluated in 75% of cases; sensitivity and specificity were 86 and 67%, respectively. Unsatisfactory results were obtained in the evaluation of mediastinal adenopathies. We conclude that magnetic resonance imaging (MRI) is useful in the preoperative evaluation of resectability criteria in patients with esophageal squamous cell carcinoma.     

自膨式带膜食道支架置入治疗食道癌的临床意义

目的探讨自膨式带膜支架置入治疗食道癌的临床意义。方法在透视监视、导丝引导下,将20个不同规格的自膨式带膜支架置入食道癌狭窄处,疏通食道,追踪观察病人临床症状改善情况。结果20例病人均取得手术成功,无一例出现严重并发症,临床症状短期内明显改善。结论自膨式带膜支架置入治疗中晚期食道癌狭窄,能很快改善病人全身情况,不适为一种有效的治疗手段,值得推广,如果结合运用动脉灌注栓塞、放疗、中药支持治疗能够明显改善病人全身情况、延长病人生存期。     

食管神经内分泌癌15例临床病理分析

目的 分析食管神经内分泌癌的临床病理学及免疫组织化学特征,为食管神经内分泌癌的病理诊断及临床治疗奠定一定基础.方法 收集新疆医科大学第一附属医院2013-01-2019-05间经手术病理证实为神经内分泌癌的患者,并进行随访,采用免疫组化方法检测嗜铬素A(CgA)、突触素(Syn)、CD56在食管神经内分泌癌中的表达.结...     

Esophageal carcinoma in Olmsted County, Minnesota, 1935-1971

In order to estimate the incidence rate of esophageal carcinoma in a defined populat;on, all cases in bona fide residents of Olmstead County, Minnesota, newly diagnosed from 1935 through 1971 were identified and reviewed. There were 33 confirmed cases. The mean annual incidence was 2.6/100,000 men and 0.8/100,000 women. The age-adjusted incidence rates in this population are lower than those reported recently from other populations. Of the 27 patients whose disease was diagnosed before death, only 1 survived more than 6 years after initial diagnosis of the esophageal carcinoma, and all had died before the end of the study.     

食管基底样鳞状细胞癌9例临床病理分析

食管基底样鳞状细胞瘤(esophagealbasaloidsquamouscell carcinoma,BSCC)为发生于上呼吸道及上消化道的恶性肿瘤,由Wain等[1]1986年首先报道。食管BSCC与低分化鳞癌形态相似,但生物学行为却不尽相同。为此作者对9例食管BSCC临床特点、病理形态、免疫组化及预后进行研究。1材料与方法收集上海第二医科大学附属瑞金医院病理科200201—200310期间BSCC9例,复习患者临床资料、组织切片并随访。标本常规处理及HE染色。所有病例均做vimentin、AE1AE3、34βE12、CEA、actin(HHF35)、S_100蛋白、NSE、chromogra ninA(CHG)、Syn、p53…     

Esophageal superficial adenosquamous carcinoma resected by endoscopic submucosal dissection: A rare case report

BACKGROUNDAdenosquamous carcinoma (ASC), which is comprised of squamous cell carcinoma (SCC) and adenocarcinoma elements, is a rare histological type of esophageal carcinoma. Few reports have focused on the endoscopic findings and the effectiveness of the endoscopic treatment of early ASC.CASE SUMMARYA 77-year-old man underwent esophagogastroduodenoscopy for heartburn. A flat lesion with an uneven and slightly elevated central portion was found in the distal esophagus. Magnifying endoscopy with narrow-band imaging showed a well-demarcated brownish area with dendritically branched abnormal vessels and highly irregular intrapapillary capillary loops. A histopathological diagnosis of SCC was obtained by endoscopic biopsy. Endoscopic ultrasonography revealed a hypoechoic mass confined to the mucosa layer. The lesion was suspected to be SCC with invasion into the muscularis mucosa. The lesion was resected en bloc by endoscopic submucosal dissection and histologically diagnosed as esophageal ASC limited within the muscularis mucosa, which was completely resected without lymphovascular or neural invasion. The SCC element was the pre-dominant element. The adenocarcinoma element formed ductal and nested structures distributed in a focal pattern. The patient underwent only endoscopic submucosal dissection and has been under annual endoscopic and radiographic surveillance for 3 years without recurrence.CONCLUSIONFor early ASC confined within the mucosal layer, complete endoscopic resection might also be a curative treatment.     

Esophageal actinomycosis

Esophageal actinomycosis is uncommon and has been reported in immunocompetent and immunocompromised patients. A 41-y-old man with a history of heavy alcohol use presented with progressively worsening odynophagia and dysphagia over a 2-wk period. Upper gastrointestinal endoscopy and esophageal biopsy revealed ulceration withActinomyces and candidal infection. After therapy with intravenous penicillin G followed by oral amoxicillin that led to clinical improvement, repeat upper gastrointestinal endoscopy revealed healing of esophageal ulceration and no evidence ofActinomyces. From this case and a review of the literature regarding clinical symptoms, diagnosis, and treatment, it is clear that esophageal actinomycosis is a cause of odynophagia and dysphagia. Upper gastrointestinal endoscopy and pathologic examination should be carefully evaluated in patients who present with odynophagia and dysphagia.     

Esophageal dysphagia

Esophageal dysphagia can arise from a variety of causes such as motility disorders, mechanical and inflammatory diseases. Adequate management includes a detailed history, evaluation with upper endoscopy, barium radiography and manometry. Treatment is usually tailored to the underlying disease process and in some cases, as in inoperable cancer, palliative management may be necessary.