Abstract
BackgroundEsophageal leiomyosarcoma (LMS) is a rare tumor that constitutes less than 1% of all malignant esophageal tumors. Concurrent occurrence of esophageal leiomyosarcoma with squamous cell carcinoma (SCC) is even rarer than isolated leiomyosarcoma.Case presentationIn this report, we present a case of concurrent leiomyosarcoma and SCC in a 64-year-old woman presenting with vomiting and solid dysphagia, which has not been properly diagnosed following several referrals and diagnostic modalities. At last Exploratory laparotomy with gastric pull-up was performed in addition to radical laryngectomy with partial resection of the esophagus and subtotal thyroidectomy. Pathologic evaluation of the surgical specimen showed concurrent LMS (5.2 × 4.5 × 3 cm) and SCC (1.5 × 0.6 × 0.6 cm) at the same anatomical level in the proximal esophagus.ConclusionsThis study proposes the importance of using ancillary diagnostic tests such as immunohistochemistry (IHC) to diagnose less common cases such as concurrent LMS and SCC.
Highlights
This study proposes the importance of using ancillary diagnostic tests such as immunohistochemistry (IHC) to diagnose less common cases such as concurrent LMS and squamous cell carcinoma (SCC)
We report a case of concurrent esophageal LMS and SCC anatomically located at the same level in a 64-year-old woman, presenting with vomiting and dysphagia, diagnosed and treated appropriately
Case presentation The patient was a 64-year-old woman with seven children brought to the hospital with severe vomiting and a history of solid dysphagia; she had the symptoms for three months and was referred to different physicians, left without definite diagnosis before admission to our center
Summary
Esophageal carcinoma is the eighth most common cancer worldwide with a poor prognosis due to its overly aggressive nature [1]. We report a case of concurrent esophageal LMS and SCC anatomically located at the same level in a 64-year-old woman, presenting with vomiting and dysphagia, diagnosed and treated appropriately. Case presentation The patient was a 64-year-old woman with seven children brought to the hospital with severe vomiting and a history of solid dysphagia; she had the symptoms for three months and was referred to different physicians, left without definite diagnosis before admission to our center. The patient was scheduled for exploratory laparotomy with the exploration of cervical organs, resection of the pharynx, thyroid (partial), and esophagus and gastric pull up along with the insertion of a tracheostomy and bilateral chest tube, and cervical penrose. The abdomen was opened by a high midline incision The surgeon inserted his finger into the mediastinum to assess the presence of any tumors. The patient underwent radiotherapy and was stable at six months’ follow-up with no recurrence
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