A Case of Esophageal Carcinoma associated with Composed of Basaloid Carcinoma and Adenosquamous Carcinoma in the Same Area

Kotaro Nambu¹⁾³⁾⁴⁾, Yoichi Tanaka¹⁾, Hirohiko Sakamoto¹⁾, Yoshiyuki Kawashima¹⁾, Katsumi Amikura¹⁾, Yoji Nishimura¹⁾, Masafumi Kurosumi²⁾, Tetsuo Shibuya³⁾⁴⁾ and Akira Tokunaga⁴⁾

Division of Gastroenterogical Surgery¹⁾ and Department of Pathology²⁾, Saitama Cancer Center Hospital
Department of Surgery, Omiya Association Hospital³⁾
Gastrointestinal Disease Center, Nippon Medical School Musasikosugi Hospital⁴⁾

We report a very rare case of esophageal carcinoma composed of basaloid carcinoma and adenosquamous carcinoma components developing from the same area. The patient was a 71-year-old male who presented with a 3-month history of swallowing difficulty. He visited a nearby hospital, and was referred to our hospital with a diagnosis of esophageal carcinoma. On endoscopic examination, a all circumference type-3 lesion was recognized 34 cm below the incisors. The lesion was diagnosed as a squamous cell carcinoma on biopsy, and complete excision of the thoracoabdominal esophagus was undertaken. Pathological examination of the excised specimens showed wide-ranging intraepithelial extension of the squamous cell carcinoma and infiltration of the basaloid carcinoma component into the submucosal layer and infiltration of the adenosquamous carcinoma component into the tunica externa. These areas of infiltration were recognized immediately beneath the carcinoma in situ. However, there was no evidence of transition from one area of infiltration to another. The findings were consistent with the diagnosis of a collision tumor. The stage was pT3pN0M0 and pStage II¹⁾. This case the presence of the two infiltrating lesions of specific histological types immediately beneath the common intraepithelially extended lesion is extremely rare. With regard to the etiopathology, it was estimated that individual infiltrative lesions had developed from the same intraepithelial squamous cell carcinoma, based on the absence of evidence of transition from one area of infiltration to another.

Key words
esophageal cancer, basaloid (-squamous) carcinoma, adenosquamous carcinoma

Reprint requests
Kotaro Nambu Department of Surgery, Omiya Association Hospital
2-125-16 Miyahara-cho, Kita-ku, Saitama, 331-8689 JAPAN

Accepted
April 23, 2008

To read the PDF file you will need Abobe Reader installed on your computer.