A case is presented of carcinoma of esophagus which developed in the site of chronic stricture caused by ingestion of a hydrochloric acid twenty-nine years previously. Esophagectomy was performed while carcinoma was still confined to the submucosal layer of the strictured esophagus. Twelve months after the operation, the patient has no evidence of recurrence. Carcinoma of the esophagus engrafted on corrosive stricture has rarely been noted. The incidence of carcinoma of the esophagus among patients with chronic esophageal strictures due to ingestion of corrosive is significantly higher than that in the general population. Diagnosis of carcinoma in these patients is often delayed, since the symptoms are blamed on corrosive stricture. However, our case revealed that carcinoma developed at the site of corrosive strictore was more apt to induce luminal obstruction before development of extrinsic spread. Therefore, some changes of dysphagia in patients with corrosive stricture should lead to thorough esophagoscopic and esophagographic examination. Histopathological examination of resected specimens from the present case revealed that a dense scar tissue in the corrosive stricture prevented early invasion of carcinoma into adjacent muscular layer of the esophageal wall. The incidence of malignant transformation of corrosive stricture does not warrant esophageal resection. However, in cases where some surgical intervention to relieve the stricture should need. resection of the esophagus with reconstruction seems to be a wiser choice than a by-pass procedure for preventing the later development of carcinoma.
