Surgery for unusual histopathologic variants of esophageal neoplasms: a report of 23 cases with emphasis on histopathologic characteristics.
BACKGROUND
Adenocarcinoma and squamous cell carcinoma are the most frequent pathologic diagnoses with esophageal malignancy. Unusual pathologic variants are encountered in only 1% to 7% of patients, and therefore data evaluating the treatment and survival in this group of esophageal neoplasms are sparse.


METHODS
To get more insight into the unusual pathologic variants, patients were selected from our computer-assisted database containing data from 426 consecutive patients treated with esophageal resection or enucleation at our institute during 1993 to 2000.


RESULTS
Uncommon variants of esophageal neoplasms were encountered in 23 patients (5.3%). The following unusual histopathologic variants were seen: basaloid squamous cell carcinoma (n = 3), small-cell carcinoma (n = 1), leiomyoma (n = 5), gastrointestinal stromal tumor (n = 2), leiomyosarcoma (n = 1), adenosquamous carcinoma (n = 5), carcinosarcoma (n = 4), collision tumor (n = 1), and melanoma (n = 1). Presentation, histopathologic characteristics, treatment, and prognosis are described in reference to the existing literature.


CONCLUSIONS
Survival data of the unusual pathologic variants seem to be comparable to those of the most frequently encountered neoplasms. Only in case of small-cell carcinoma does there seem to be a definite role for chemotherapy, especially in a multimodality treatment protocol.
Klaase
J M
JM
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. j.klaase@ziekenhuis-mst.nl
Hulscher
J B F
JB
Offerhaus
G J A
GJ
ten Kate
F J W
FJ
Obertop
H
H
van Lanschot
J J B
JJ
D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000473:pathology* / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D016208:Databases, Factual; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013534:Survival