A Case of Esophageal Carcinosarcoma of which Carcinoma Component was Small Cell Carcinoma

Masahiro Komoto, Tsutomu Takashima, Bunzo Nakata, Shinya Nomura¹⁾, Toru Inoue¹⁾, Yoshito Yamashita¹⁾, Masaichi Ohira¹⁾, Kenichi Wakasa²⁾ and Kosei Hirakawa¹⁾

Department of Surgery Oncology, Osaka Socio-Medical Center
Department of Surgical Oncology, Osaka City University Graduate School of Medicine¹⁾
Department of Pathology, Osaka City University Hospital²⁾

A 54-year-old man seen for swallowing discomfort was found on an upper gastrointestinal series to have a smooth protruding lesion on the posterior wall of the middle thoracic esophagus. Endoscopic examination showed a slightly reddish lesion about 2.5 cm in diameter unstained by iodine. Pathological examination of biopsy specimens showed poorly differentiated squamous cell carcinoma, necessitating esophagectomy through a thoracolaparotomy. The 2.5× 2.0 cm polipoid tumor consisted of small-cell carcinoma and chondrocytes invading to the adventitia. Positive staining was recognized for CAM 5.2 immunohistochemically in semi serial histologic sections of the transitional zone from small-cell carcinoma to chondrocytes. After adjuvant chemotherapy with low-dose cisplatin plus 5-FU, the patient was discharged without major complications. A patient with two cancerous components who survives and recurrence free for 15 months after surgery is rare, especially considering that both carcinosarcoma and small-cell carcinoma are disease and are potentially highly malignant.

Key words
esophageal cancer, carcinosarcoma, small cell carcinoma

Reprint requests
Tsutomu Takashima Department of Surgery, Osaka Socio-Medical Center
1-3-44 Haginochaya, Nishinari-Ku, Osaka, 557-0004 JAPAN

Accepted
July 28, 2004

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