Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Pinghai Road, Suzhou, 215000, Jiangsu, China.
J Cardiothorac Surg. 2022 Aug 26;17(1):210. doi: 10.1186/s13019-022-01957-w.
Esophageal carcinosarcoma (ECS) is a rare malignant tumor that often presents as an intraluminal polypoid lesion in the esophageal lumen. The pathogenesis of esophageal carcinosarcoma is not clear and its etiology is still being discussed.
We report the case of a 68-year-old male who had dysphagia for approximately three months. Contrast-enhanced computed tomography showed an irregular enhancing mass in the lower esophagus. Endoscopy showed a gray-white mass with a smooth surface that almost filled the esophageal lumen at a location 28 cm from the incisor tooth. Considering the location of the tumor, we opted for Ivor-Lewis esophagectomy with intrathoracic anastomosis through a 5-port laparoscope and uniport video-assisted thoracic surgery (VATS). Pathological analysis showed that the mass comprised carcinoma in situ and pleomorphic sarcoma, without lymphatic metastasis. The postoperative pathological stage was T1bN0M0, stage I (Japanese Classification of Esophageal Cancer 11th Edition). The latest follow-up of the patient was 14 months after the surgery, and no signs of recurrence or metastasis were found.
This case demonstrates a rare esophageal malignancy with a peculiar histological composition. Successful VATS esophagectomy with intrathoracic anastomosis was conducted without recurrence or metastasis at the 14-month follow-up.
食管骨肉瘤(ECS)是一种罕见的恶性肿瘤,常表现为食管腔内的腔内息肉样病变。食管骨肉瘤的发病机制尚不清楚,其病因仍在讨论中。
我们报告了一例 68 岁男性,吞咽困难约三个月。增强 CT 显示食管下段不规则强化肿块。内镜检查显示灰白色肿块,表面光滑,位于门齿后 28cm 处几乎充满食管腔。考虑到肿瘤的位置,我们选择了经腹腔镜和单孔胸腔镜下经胸 5 孔 Ivor-Lewis 食管癌切除术和胸内吻合术。病理分析显示肿块由原位癌和多形性肉瘤组成,无淋巴转移。术后病理分期为 T1bN0M0,Ⅰ期(日本食管癌第 11 版分类)。患者术后随访最新时间为 14 个月,未见复发或转移迹象。
本例为罕见的具有特殊组织学成分的食管恶性肿瘤。成功实施了经胸 5 孔腹腔镜和单孔胸腔镜下食管癌切除术和胸内吻合术,14 个月随访无复发或转移。