Adenosquamous Carcinoma Arising in Pedunculated Hamartoma of the Esophagus, Report of a Case Kohzo Nakagawa 1 , Fumio Konishi 2 , Osao Nakaizumi 1 , Shin Yamazaki 1 1Department of Surgery, Fukui Prefectural Hospital 2Department of Pathology, Kanazawa Medicial University pp.1271-1278
Published Date 1988/11/25
DOI https://doi.org/10.11477/mf.1403108782
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 A 67-year-old man was admitted to our hospital with a complaint of sensation of obstruction in the throat in April 1982. He had a history of gastrectomy for gastric ulcer in 1972. A pedunculated polyp of the upper esophagus was noticed at postoperative x-ray examination in December 1977 (Fig. 1).

 Endoscopic examination showed an elonged, thumbshaped polypoid tumor with a smooth surface at 19 cm distant from the incisor teeth in January 1978 (Fig. 3).

 Biopsy specimen taken from the tumor showed no changes except for squamous epithelium with subepithelial lymphoid follicles. He had been followed by endoscopic and fluoroscopic examination because of no complaint of swallowing disturbance at that time. The examinations from 1977 to 1982 revealed no remarkable changes in size but increasing surface irregularity (Fig. 4 a, b).

 He started to complain of sensation of obstruction in the throat four years later from initial examination, so that endoscopic biopsy was done in April 1982. As the biopsy specimen showed a pooly differentiated squamous cell carcinoma, the tumor was resected endoscopically under the considerations of his general condition and past history. Resected specimen showed thumb-shaped polypoid tumor measuring 3.0×1.4 cm in size (Fig. 5).

 Histologically, tumor consisted of lymphoid tissue, adipose tissue, esophageal glands, nerve, vein, hyalinized fibrous tissue and several cysts resembling esophageal ducts. The lining epithelium as well as subepithelial area was mostly occupied by squamous cell carcinoma and there are areas with features of both squamous and glandular carcinomas. Mucicarmine and alcian-blue stains demonstrated that most of the glandular structures secreted mucin substance (Figs. 6~11). Our final diagnosis was adenosquamous carcinoma (including mucoepidermoid carcinoma) arising in the pedunculated hamartoma of the esophagus. It was presumed, though not proved, that the carcinoma had its origin in the esophageal glands. The patient is well as of December 1986 with no sings suggestive of recurrence.

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