Shirahata Toru, Takeshita Tatsuya, Maeda Yuka, Shimizu Ken
Department of Respirology, Japan Community Health Care Organization (JCHO) Saitama Medical Center, Saitama City, Saitama, Japan.
Department of Gastroenterology, Japan Community Health Care Organization (JCHO) Saitama Medical Center, Saitama City, Saitama, Japan.
Am J Case Rep. 2019 Apr 4;20:447-452. doi: 10.12659/AJCR.913782.
BACKGROUND Pseudomesotheliomatous carcinomas are rare tumors that develop like malignant pleural mesothelioma (MPM). These tumors have similar features, and thus pseudomesotheliomatous carcinomas can sometimes be misdiagnosed as MPM. Most pseudomesotheliomatous carcinomas develop from primary lung cancers, although there have been some reports involving other malignancies; however, there has been no report describing a pseudomesotheliomatous carcinoma developing from an esophageal squamous cell carcinoma (ESCC). To the best of our knowledge, this is the first case report describing pseudomesotheliomatous carcinoma originating from primary ESCC. CASE REPORT A 65-year-old man was admitted to our hospital because of persistent cough and right chest pain. Radiological examination suggested MPM, and a high concentration of pleural hyaluronic acid was also observed. Cytological examination of pleural effusion confirmed metastatic squamous cell carcinoma, and ESCC was confirmed by upper-gastrointestinal endoscopy. The patient received cisplatin and 5-FU combination chemotherapy as first-line treatment, and docetaxel chemotherapy as second-line treatment. However, the patient's condition deteriorated, and he died 6 months after the diagnosis was established. We performed an autopsy and found that ESCC had invaded the lung, pleura, peritoneum, liver, stomach, ureter, bladder, spine, and lymph nodes. CONCLUSIONS We demonstrated that primary ESCC can give rise to a pseudomesotheliomatous carcinoma. This report describes the clinical features and outcome of such a patient, with an emphasis on differential diagnosis of MPM.
背景 假性间皮瘤样癌是一种罕见的肿瘤，其发展过程类似于恶性胸膜间皮瘤（MPM）。这些肿瘤具有相似的特征，因此假性间皮瘤样癌有时会被误诊为MPM。大多数假性间皮瘤样癌起源于原发性肺癌，尽管也有一些涉及其他恶性肿瘤的报道；然而，尚无关于食管鳞状细胞癌（ESCC）发展为假性间皮瘤样癌的报道。据我们所知，这是首例描述源自原发性ESCC的假性间皮瘤样癌的病例报告。病例报告 一名65岁男性因持续咳嗽和右胸痛入院。影像学检查提示为MPM，同时还观察到胸膜透明质酸浓度升高。胸腔积液的细胞学检查证实为转移性鳞状细胞癌，上消化道内镜检查确诊为ESCC。患者接受顺铂和5-氟尿嘧啶联合化疗作为一线治疗，多西他赛化疗作为二线治疗。然而，患者病情恶化，确诊后6个月死亡。我们进行了尸检，发现ESCC已侵犯肺、胸膜、腹膜、肝脏、胃、输尿管、膀胱、脊柱和淋巴结。结论 我们证明原发性ESCC可引发假性间皮瘤样癌。本报告描述了此类患者的临床特征和结局，重点在于MPM的鉴别诊断。
