Abstract
The patient was a 77-year-old man who presented to our hospital because of epigastralgia 7 years earlier, when an esophagogastroduodenoscopy revealed a small granule like mass white in color, completely encircling the circumference from the lower esophagus to the esophagogastric junction (EGJ). Symptomatic remission was gained by oral intake of H2-blocker, and thereafter he had not presented to our clinic until 9 months earlier when he presented with the same symptom. We confirmed a whole circumferential ulcer at the EGJ, and a similar white mass completely encircling the lower esophagus where was proximal to the EGJ, with a warty projecting mass. An oral medication resulted in a temporary remission, but the same symptom recurred one month earlier. Reexamination revealed whole circumferential irregular erosion at the EJG to cause stricture. A biopsy of the stricture disclosed squamous cell carcinoma, so that lower esophagectomy and reconstruction using a gastric tube were performed. The histopathological diagnosis was well differentiated squamous cell carcinoma reaching the adventitia ; further, the proximal white mass revealed extremely mild atypia associated with papillary growth including keratinization. Since the both were a continuing lesion, verrucous carcinoma (VC) of the esophagus was diagnosed.
This paper deals with a case of VC of the esophagus which arose in the esophagus, followed a delayed course, and rapidly progressed after a long lapse of 7 years.
