Primary esophageal combined carcinoma is very rare. The authors herein report 2 cases. Case 1 was a com- bined squamous cell carcinoma and small cell carci- noma, and case 2 was a combined squamous cell carci- noma, a...Primary esophageal combined carcinoma is very rare. The authors herein report 2 cases. Case 1 was a com- bined squamous cell carcinoma and small cell carci- noma, and case 2 was a combined squamous cell carci- noma, adenocarcinoma, and small cell carcinoma. Case 1 was a 67-year-old man with complaints of dysphagia. Endoscopic examination revealed an ulcerated tumor in the middle esophagus, and 6 biopsies were obtained. All 6 biopsies revealed a mixture of squamous cell car- cinoma and small cell carcinoma. Both elements were positive for cytokeratin, epithelial membrane antigen, and p53 protein, and had high Ki-67 labeling. The small cell carcinoma element was positive for synaptophysin, CD56, KIT, and platelet-derived growth factor-~ （PDG- FRA）, while the squamous cell carcinoma element was not. Genetically, no mutations of K/Tand PDGFRA were recognized. The patient died of systemic carcinomato- sis 15 mo after presentation. Case 2 was a 74-year-old man presenting with dysplasia. Endoscopy revealed a polypoid tumor in the distal esophagus. Seven biopsies were taken, and 6 showed a mixture of squamous cell carcinoma, small cell carcinoma, and adenocarcinoma. The 3 elements were positive for cytokeratins, epithe-lial membrane antigen, and p53 protein, and had high Ki-67 labeling. The adenocarcinoma element was posi- tive for mucins. The small cell carcinoma element was positive for CD56, synaptophysin, KIT, and PDGFRA, but the other elements were not. Mutations of KIT and PDGFRA were not recognized. The patient died of sys- temic carcinomatosis 7 mo after presentation. These combined carcinomas may arise from enterochromaf- fin cells or totipotential stem cell in the esophagus or transdifferentiation of one element to another. A review of the literature was performed.展开更多
文摘Primary esophageal combined carcinoma is very rare. The authors herein report 2 cases. Case 1 was a com- bined squamous cell carcinoma and small cell carci- noma, and case 2 was a combined squamous cell carci- noma, adenocarcinoma, and small cell carcinoma. Case 1 was a 67-year-old man with complaints of dysphagia. Endoscopic examination revealed an ulcerated tumor in the middle esophagus, and 6 biopsies were obtained. All 6 biopsies revealed a mixture of squamous cell car- cinoma and small cell carcinoma. Both elements were positive for cytokeratin, epithelial membrane antigen, and p53 protein, and had high Ki-67 labeling. The small cell carcinoma element was positive for synaptophysin, CD56, KIT, and platelet-derived growth factor-~ （PDG- FRA）, while the squamous cell carcinoma element was not. Genetically, no mutations of K/Tand PDGFRA were recognized. The patient died of systemic carcinomato- sis 15 mo after presentation. Case 2 was a 74-year-old man presenting with dysplasia. Endoscopy revealed a polypoid tumor in the distal esophagus. Seven biopsies were taken, and 6 showed a mixture of squamous cell carcinoma, small cell carcinoma, and adenocarcinoma. The 3 elements were positive for cytokeratins, epithe-lial membrane antigen, and p53 protein, and had high Ki-67 labeling. The adenocarcinoma element was posi- tive for mucins. The small cell carcinoma element was positive for CD56, synaptophysin, KIT, and PDGFRA, but the other elements were not. Mutations of KIT and PDGFRA were not recognized. The patient died of sys- temic carcinomatosis 7 mo after presentation. These combined carcinomas may arise from enterochromaf- fin cells or totipotential stem cell in the esophagus or transdifferentiation of one element to another. A review of the literature was performed.
