Carcinosarcoma of the esophagus is a rare malignant neoplasm composed of both carcinomatous and sarcomatous elements. The patient, a 71-year-old male, presented with swalling difficulties. A large tumor was found on radiologic imagings in the upper thoracic esophagus, and sarcoma was diagnosed by endoscopic biopsy. Thoracic esophagectomy was followed by cervical, mediastinal and abdominal lymph node dissection. The polypoid tumor, 8 × 4 × 2 cm in size, was composed of carcinomatous and sarcomatous elements histologically. Additional immunohistochemical examinations disclosed EMA (epithelial membrane antigen) and Vimentine-positive cells in the sarcoma-like element. According to the Guide Lines for Clinical and Pathological Studies on Carcinoma of the Esophagus, this case was diagnosed as so called carcinosarcoma. Cervical para-esophageal lymph node metastasis was histologically confirmed. Radical esophagectomy with lymph node dissection may be recommended for carcinosarcoma of the esophagus if permited by the general condition of the patient.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)