PMC7415637_01
Esophagogastroscopy and barium esophagography were performed for esophageal carcinosarcoma on the patient's first visit. (a) Esophagogastroscopy with Lugol staining revealed a superficial lesion with a polypoid mass in the middle thoracic esophagus. (b) The polypoid mass was continuous with the superficial lesion and was attached by a thin pedicle (arrow). (c) A barium esophagram revealed a 20-mm mass in the middle thoracic esophagus (arrow).
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Esophagogastroscopy revealed a polypoid tumor that was continuous with the superficial lesion and attached by a thin pedicle in the mid-thoracic esophagus 28 cm from the incisor teeth (Fig. 1a, b). A barium esophagogram revealed a polypoid tumor, 20 mm in diameter, in the mid-thoracic esophagus (Fig. 1c).
Histopathological examination of endoscopic biopsy specimens from the esophagus (hematoxylin-eosin stain; high-power field). (a) Pathological finding of the biopsy specimen from the superficial lesion showed moderately differentiated squamous cell carcinoma. (b) Pathological finding of the biopsy specimen from the polypoid mass showed atypical spindle-shaped cells.
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Histopathological examination of the endoscopic biopsy specimen showed moderately differentiated squamous cell carcinoma in the superficial lesion and a sarcomatous element consisting of atypical spindle-shaped cells in the polypoid portion of the tumor (Fig. 2).
Esophageal surgical specimen. No polypoid mass was observed, and only the superficial lesion with erosion was detected.
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In the resected specimen, only a Lugol-unstained superficial lesion 20 x 16 mm in size was observed in the upper thoracic esophagus, whereas the polypoid tumor already sloughed off (Fig. 3).
Pathological examination of surgical specimens. A slightly depressed lesion with erosion was observed (arrow). Atypical squamous cells invaded the muscularis mucosae. (a) Hematoxylin-eosin stain; 40x magnification. (b) Hematoxylin-eosin stain; high-power field.
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Pathologically, only squamous cell carcinoma that invaded the muscularis mucosae was observed around the central ulcer (Fig. 4), as the sarcomatous element was not observed in the resected specimen.