A Case of Pedunculated Pseudosarcoma Arising from the Abdominal Esophagus Concomitant with Multifocal Superficial Cancer of the Esophagus

Yoshihide Otani, Yasuyuki Tokura, Kazuo Yamafuji, Tetsuya Takahashi, Satoshi Aiko, Kazuo Kishi, Syunya Fujii, Keizo Katsumata, Toshiaki Kawai*, Toshiharu Ishii**

Department of Surgery, Urawa Municipal Hospital
*First Department of Pathology, National Defense Medical College
**Department of Pathology, Hachioji Medical Center, Tokyo Medical College

A 60-year-old man with a three-month history of vague symptoms of dysphagia was admitted to Urawa Municipal Hospital on April 8, 1992. Upper gastrointestinal barium examination revealed a bulky mass (13×7×6 cm) occupying the upper half of the stomach. Endoscopy revealed a large pedunculated tumor arising from the abdominal esophagus and suspended into the stomach. Lugol staining method disclosed multiple superficial lesions on the middle and lower third of the esophagus. Biopsied specimens revealed spindle-shaped sarcomatous cells in the bulky mass and multifocal squamous cell carcinoma in the esophagus. Thoracic esophagectomy with lymph node dissection and gastric tube reconstruction was performed. Based on immunohistochemical and electron microscopic findings, the tumor was diagnosed as spindle cell carcinoma (pseudosarcoma). The involvement of squamous cell carcinoma in pericardiac and celiac lymph nodes was observed. After postoperative adjuvant chemotherapy using cisplatin (125 mg/body), the patient was discharged on 39th postoperative day. Fourteen months have passed without recurrence since the operation.

Key words
esophageal cancer, carcinosarcoma, pseudosarcoma

Reprint requests
Yoshihide Otani Department of Surgery, School of Medicine, Keio University
35 Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
December 8, 1993

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