A Case of Esophageal Carcinoma, which Responded to Radiochemotherapy, Covering the Surface of Esophageal Leiomyoma

Hideaki Shimizu, Yoshiro Ogata, Kunihiro Toyama, Iwao Ozawa, Takao Inada, Junichi Matsui, Shoichi Hishinuma, Kenjiro Kotake, Yasuo Koyama

Department of Surgery, Tochigi Cancer Center

A 54-year-old man had an abnormal finding of the esophagus detected during a medical examination in June 1990. An upper GI series revealed an elevated lesion, measuring 20×16×10 mm, arising from the anterior wall of the upper esophagus. The lesion, with a slight erosion on its surface, was diagnosed as an esophageal carcinoma in accord with a superficial elevated type of the endoscopic classification. The histological findings on the biopsied specimen taken from the surface of the lesion showed squamous cell carcinoma. Radiation therapy at a dose of 50 Gy was delivered in combination with 2 cycles of continuous IV infusion of 5-fluorouracil and cisplatin at doses of 1,000 and 25 mg/m²/day respectively for 5 days. No reduction of the tumor mass was seen after the treatment. Resection was carried out on March 7, 1991. The histological findings on the resected specimen showed that the elevated lesion was composed of leiomyoma derived from the muscularis mucosa, and the epithelium on its surface contained no cancer cells. The carcinoma covering the surface of the coexisting leiomyoma had disappeared as a result of the radiochemotherapy and only the leiomyoma component remained unchanged.

Key words
esophageal cancer, esophageal leiomyoma, neoadjuvant therapy

Reprint requests
Hideaki Shimizu Department of Surgery, Tochigi Cancer Center
4-9-13, Younan, Utsunomiya, 320 JAPAN

Accepted
December 10, 1991

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