A CASE OF ESOPHAGEAL CARCINOSARCOMA HANGING DOWN INTO THE STOMACH

概要

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We report herein on a case of esophageal carcinosarcoma hanging down into the stomach. A 67-year-old man was referred to our hospital for investigation of a gastric lesion. A barium esophagogastrogram showed a huge elevated lesion in the cardiac portion. Endoscopic examination showed a nodular spherical tumor with coarse mucosa and partial furring, with a blood clot. It was not visible in the root of the tumor, but esophageal mucosa prolapse into the stomach was recognized. The lesion was diagnosed as a poorly differentiated carcinoma by endoscopic biopsy. We diagnosed it as gastric cancer and had planned a total gastrectomy. Intraoperative findings, however, revealed that the root of the tumor was located within the esophagus, so our diagnosis was esophageal cancer (suspected carcinosarcoma). We performed a partial esophagectomy and proximal gastrectomy. The surgical specimen showed that the pedunculated tumor existing in the stomach had arisen from the esophageal mucosa at 1 cm orally from the esophago-gastric junction. The histological findings produced a diagnosis of carcinosarcoma of the esophagus. We believed that the tumor had grown within the esophagus and dropped down into the stomach with as its weight and volume increased. This patient was a very rare case. Endoscopic findings are important for preoperative diagnosis of esophageal carcinosarcoma.
一般社団法人日本消化器内視鏡学会の論文