Ikura Y, Hosotani R, Aoyama H, Ogata M, Hayashi M, Takamine Y, Uchida H, Shirane H, Ishikawa T
Second Department of Surgery, Kobe City General Hospital, Japan.
Surg Today. 1993;23(6):562-7. doi: 10.1007/BF00730636.
Among 137 cases of esophageal neoplasms surgically treated at Kobe City General Hospital from 1983 to 1990, there were two patients with a huge polypoid lesion identified as carcinosarcoma by light microscopic examination, both of whom underwent radical resection and esophagogastrostomy. Microscopic examination of the resected specimens revealed the tumors to be composed of carcinomatous and sarcomatous elements. Additional immunohistochemical examination disclosed keratin-positive cells in the carcinomatous element and vimentin-positive cells in the sarcomatous element. In case 1, keratin-positive cells were also found in the sarcomatous element, which suggested that the sarcomatous cells were derived from epithelial cells. Despite the huge size of the tumors, the depth of invasion to the esophageal wall was limited to the mucosal layer in case 1 and the submucosal layer in case 2, and there has been no evidence of recurrence in either case since surgery.
1983年至1990年期间,在神户市立综合医院接受手术治疗的137例食管肿瘤患者中,有2例患者存在巨大息肉样病变,经光镜检查确诊为癌肉瘤,这两名患者均接受了根治性切除及食管胃吻合术。对切除标本的显微镜检查显示,肿瘤由癌性和肉瘤性成分组成。进一步的免疫组化检查发现,癌性成分中有角蛋白阳性细胞,肉瘤性成分中有波形蛋白阳性细胞。在病例1中,肉瘤性成分中也发现了角蛋白阳性细胞,这表明肉瘤细胞来源于上皮细胞。尽管肿瘤体积巨大,但病例1中肿瘤侵犯食管壁的深度仅限于黏膜层,病例2中为黏膜下层,自手术以来,两例均无复发迹象。