Four Cases of Esophageal Carcinosarcoma

Abstract

Esophageal carcinosarcoma is a relatively rare histological type, accounting for 0 . 5 to 2 . 8% in esophageal malignancies. Here we report 4 cases of esophageal carcinosarcoma on which we performed thoracoscopic subtotal esophagectomy during the approximately five months from July 2017 to November 2017. All patients were male (mean age 76 years). One of the 4 patients was asymptomatic, and the other 3 presented dysphagia or cervical discomfort. Endoscopic examination showed type 0-I tumor in all patients. Based on pathological biopsy examination, 2 of the 4 patients were diagnosed with carcinosarcoma or suspected carcinosarcoma, and the other 2 were diagnosed with squamous cell carcinoma. Only 1 patient received preoperative chemotherapy with 5FU/CDDP. Thoracoscopic subtotal esophagectomy with extended lymphadenectomy was performed in all patients. The postoperative pathological diagnosis was carcinosarcoma with submucosal layer invasion in all patients. The only patient who received preoperative chemotherapy had station 2 lymph node metastasis. The average observation period is 2 years and 2 months, and all patients remain alive without recurrence at this stage. When we detect a pedunculated esophageal tumor, it is necessary to keep in mind the potential of carcinosarcoma, subject to careful examination. At the moment, there is no standard therapy for esophageal carcinosarcoma, but treatment based on esophagectomy with extended lymphadenectomy is considered appropriate.