A Case of Submucosal Basaloid Carcinoma of Cervico-thoracic Esophagus

Abstract

A 64-yera-old man admitted with dysphagia in January 2002 was found after swallowing barium to have a localized elevated lesion 25 mm long in the cervico-thoracic esophagus. Endoscopy showed a wide-based polypoid lesion 20 cm from the incisor on the right side of the esophagus. The lesion was suspected to have invaded the muscular layer by endoscopic ultrasonography (EUS), however, metastatic lesion was not detected by computed tomography (CT) or ultrasonography (US). Thoracoscopic esophagectomy and extended lymph node dissection were done on May 8^th, 2002, with staging of T2N0M0, Stage 2. The lesion was a wide-based 22×16mm polypoid, macroscopically. Histological study showed basaloid carcinoma invading the submucosal layer with mild blood vessel invasion, but lymphatic invasion and lymph node metastasis were not seen. Basaloid carcinoma is associated with a poor prognosis, and rarely found in the cervico-thoracic esophagus. A good prognosis can be expected when invasion is limited to the submucosal layer. The patient is under meticulous care for recurrence because of the high expression of Ki-67, which indicates high cell proliferation.