A Case of Esophageal So-called Carcinosarcoma, which Proliferated after Radiochemotherapy Against Squamous Cell Carcinoma

Shozo Sasaki, Yoshiyuki Kurosaka, Kohziro Funaki, Yoshio Michiwa, Shigeru Takegawa, Masato Kiriyama, Atsuhiro Kawashima* and Yasuhiko Kojima

Department of Surgery and Department of Clinical Laboratory*, Kanazawa Medical Center

A 89-year-old woman undergoing fibroptic esophagoscopy elsewhere for dysphagia was found to have an esophageal tumor and was referred to our hospital. Upper gastrointestinal endoscopy showed a type 1 esophageal tumor about 3 cm in diameter in the lower thoracic esophagus pathologically diagnosed as moderately differentiated squamous cell carcinoma from the biopsy specimen. CT and MRI showed metastasis in the right lymph node of cardia. Although we advised an esophagectomy, she did not agree to it due to her high age, so we treated her with radiochemotherapy. She underwent radiotherapy (54 Gy) and chemotherapy (cisplatin and 5-FU) concurrently. It was effective and the tumor almost disappeared and the biopsy specimen showed few viable cells. After 12 months, the tumor recurred and the pathological diagnosis was so-called carcinosarcoma. She died 14 months after treatment and pathological autopsy showed the tumor of the esophagus to be so-called carcinosarcoma, but metastasized tissue consisted of squamous cell carcinoma and did not have a sarcoma component. We concluded that metaplastic change of squamous carcinoma cells into spindle cells, occurred due to radiochemotherapy and the tumor recurred as so-called carcinosarcoma.

Key words
carcinosarcoma, esophageal carcinoma, radiochemotherapy

Reprint requests
Shozo Sasaki Department of Gastroenterological Surgery, Keiju Medical Center
94 Tomioka-cho, Nanao, 926-8605 JAPAN

Accepted
July 26, 2006

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