Frieling Thomas, Kreysel Christian, Blank Michael, Müller Dorothee, Euler P, Melchior Ilka, Wullstein Christoph, Hemmerlein Bernhard
Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany.
Department of Visceral Surgery, HELIOS Clinic Krefeld.
Z Gastroenterol. 2020 Oct;58(10):971-974. doi: 10.1055/a-1231-5820. Epub 2020 Oct 9.
Verrucous carcinoma of the esophagus is a rare disease leading to dysphagia, chest pain, and weight loss. The diagnosis is difficult because even repeated biopsies are often without tumor evidence. We present a patient with verrucous carcinoma of the esophagus and a literature review.
A 64-year-old patient with dysphagia and sore throat received esophagogastroduodenoscopy illustrating segmental circumferential verrucous inflammation and Candida esophagitis in the middle part of the esophagus. Repeated mucosal biopsies revealed reactive hyperkeratosis of the squamous epithelium with minimal atypia but without ulcera, eosinophilic esophagitis, or suspicion of cancer. Mucosal infection with adenovirus, herpes simplex virus 1, human papilloma virus types, and cytomegaly virus was ruled out. Veruccous carcinoma was detected finally by endoscopic mucosal resection. The patient was successfully treated by esophageal resection. Tumor stage was G1, pT1b, pN0, L0, V0, Pn0, R0.
The results suggest that macroscopic suspicion of verrucous esophageal carcinoma should lead to resections of larger tissue specimens by EMR to confirm the diagnosis.
食管疣状癌是一种罕见疾病，可导致吞咽困难、胸痛和体重减轻。诊断困难，因为即使重复活检通常也无肿瘤证据。我们报告一例食管疣状癌患者并进行文献复习。
一名64岁吞咽困难和咽痛患者接受了食管胃十二指肠镜检查，显示食管中部节段性环形疣状炎症和念珠菌性食管炎。重复黏膜活检显示鳞状上皮反应性角化过度，异型性极小，但无溃疡、嗜酸性食管炎或癌症可疑迹象。排除了腺病毒、单纯疱疹病毒1型、人乳头瘤病毒各型和巨细胞病毒的黏膜感染。最终通过内镜黏膜切除术检测出疣状癌。患者通过食管切除术成功治疗。肿瘤分期为G1、pT1b、pN0、L0、V0、Pn0、R0。
结果表明，对食管疣状癌的宏观怀疑应促使通过内镜黏膜切除术切除更大的组织标本以确诊。
