Abstract
A 66-year-old man presented with epigastralgia and dysphagia. An irregular protruding lesion with an ulcer at the esophagogastric junction was seen endoscopically and on an upper gastrointestinal series. Abdominal CT scan showed enlarged lymph nodes near the left gastric artery and cardia, but we did not recognize malignancy in the biopsy specimen. The patient's condition deteriorated due to esophageal stenosis, therefore we performed total gastrectomy and lower esophagectomy. Macroscopicically, the resected specimen showed a protruding lesion with an irregular surface, which was covered with white epithelium. Histopathologically, the tumor consisted of squamous epithelium with little atypia, invading the deeper layer of the muscular layer of the esophagus. Furthermore the basal cell layer was stained by Ki-67 immunostaining, we finally diagnosed verrucous carcinoma of the esophagus. Verrucous caricinoma is a variant of well-differentiated squamous cell carcinoma and is very rare in esophageal cancer. We discussed our case based on a review of the literature.
