Mewa Kinoo Suman, Maharaj Kapil, Singh Bhugwan, Govender Michelle, Ramdial Pratistadevi Kanaye
Suman Mewa Kinoo, Kapil Maharaj, Bhugwan Singh, Department of Surgery, Nelson R Mandela School of Medicine, University of Kwazulu Natal, Durban 4013, South Africa.
World J Gastroenterol. 2014 Jun 14;20(22):7055-60. doi: 10.3748/wjg.v20.i22.7055.
Mucoepidermoid carcinoma (MEC) is a rare primary esophageal malignancy. It is characterized by poor clinical recognition, pre-operative diagnostic challenges and a lack of standardized therapeutic guidelines. We report the clinicopathological features of a hitherto unreported variant of esophageal MEC, sclerosing MEC with "tissue eosinophilia", in a mid-esophageal location in a 51-year-old female. The diagnosis of the initial biopsy was challenging, because of the small size, poor orientation and inadequate representation of the MEC components. Recognition of the resectability of the tumor prompted surgical resection and enabled a demonstration of the low grade foci containing intermediate cells, mucin pools and the hitherto undescribed presence of stromal sclerosis and tissue eosinophils in esophageal MEC. Heightened clinicopathological awareness of esophageal MEC facilitated a definitive diagnosis and patient management. Increased recognition and global documentation of esophageal sclerosing MEC with "tissue eosinophilia" is necessary to improve the understanding and diagnosis of this malignancy in this location and to improve management guidelines.
黏液表皮样癌（MEC）是一种罕见的原发性食管恶性肿瘤。其特点是临床识别困难、术前诊断具有挑战性且缺乏标准化的治疗指南。我们报告了一例位于食管中段的51岁女性患者，患有一种此前未报道过的食管MEC变异型，即伴有“组织嗜酸性粒细胞增多”的硬化性MEC的临床病理特征。最初活检的诊断具有挑战性，因为MEC成分体积小、定位不佳且显示不充分。认识到肿瘤可切除促使进行手术切除，并得以证实低级别病灶中含有中间细胞、黏液池以及食管MEC中迄今未描述的间质硬化和组织嗜酸性粒细胞的存在。提高对食管MEC的临床病理认识有助于明确诊断和患者管理。增加对伴有“组织嗜酸性粒细胞增多”的食管硬化性MEC的认识并进行全球记录，对于增进对此部位该恶性肿瘤的理解和诊断以及改进管理指南是必要的。
