PMC2833302_01
The proximal portion of the nodular tumor as seen on endoscopy of the esophagus. At time of this endoscopy, there was a severe stricture secondary to the tumor and a 6 mm scope was unable to be passed beyond it.
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fig1
The work up continued with an esophagogastroduodenoscopy, which showed an ulcerated lesion extending from 20 to 30 cm from the incisors (Figure 1).
Pathology slide. (a) Tumor cells from the esophageal mass shown to be negative for pankeratin, with presence of actin being equivocal. (b) The submucosa of the esophagus contains mitotically active spindle cells and pleomorphic spindle cells with eosinophilic cytoplasm and focal areas containing eosinophilic stromal hyaline-like material, likely osteoid.
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fig2
The tumor cells were noted to be vimentin positive, but negative for cytokeratin, desmin, CD117, Melanin, CD45, CD3 and CD20:further supporting the diagnosis of EOO (Figure 2).
Lobulated, calcified esophageal mass at T4 level, as seen on CT scan. The mass almost completely surrounds the trachea and essentially obliterates the esophagus. Extensive calcification of a soft tissue mass and its presumed metastases should make one consider EOO as a possible diagnosis.
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fig3
A PET/CT revealed an extensive, calcified, lobulated esophageal mass (Figure 3) with intense FDG avidity extending from T1 to T8, approximately 16 cm in length.