A CASE WHICH WAS ASSUMED TO BE PRIMARY ‘TRUE CARCINOSARCOMA’ OF THE ESOPHAGUS

Abstract

We experienced a case which was assumed to be‘true carcinosarcoma’ of the esophagus. The patient was a 59-year-old man complaining of epigastric pain and dysphagia. The lesion was present in the middle intrathoracic esophagus, and was a giant polypoid lesion. A total excision of the thoracic esophagus with three regional dissection was performed. Histopathologically, it was diagnosed as carcinosarcoma of the esophagus. On HE staining, the tumor was mostly composed of sarcoma comprizing of mainly spindle cells, with nest like coexistence of well-differentiated squamous cell carcinoma with keratinization, but no transitional area between two components were seen. Immunohistochemical stainings clearly distinguished the two portions, namely the squamous cell carcinoma portion as positive for keratin and EMA versus the sarcoma portion as positive for α-SMA. Based on these findings together with electron microscopic findings, the tumor was considered to be‘true carcinosarcoma’ of the esophagus.