title: True carcinosarcoma of the esophagus: report of a case.
abstract: Carcinosarcoma of the esophagus is a malignant neoplasm involving both carcinomatous and sarcomatous components. We report a patient with true esophageal carcinosarcoma who underwent laparoscopy-assisted surgery. An upper gastrointestinal barium study revealed a lobulated intraluminal filling defect in the lower intrathoracic esophagus. The patient underwent esophagectomy and regional lymphadenectomy with gastric tube reconstruction by laparoscopy-assisted surgery and thoracotomy. The esophageal hiatus was entered and the mediastinal esophagus was dissected using a laparoscopic approach. Microscopically, the tumor comprised poorly differentiated squamous cell carcinoma and spindle-shaped cells resembling leiomyosarcoma. Immunohistochemically, spindle-shaped sarcomatous cells displayed strongly positive reaction to vimentin and negative reaction to cytokeratin AE1/AE3 and CD68. No transitional zone was seen between sarcomatous and carcinomatous elements. The patient was finally diagnosed with true esophageal carcinosarcoma. Laparoscopic transhiatal esophagectomy seems to be a rational and safe procedure for lower esophageal neoplasms, even for patients with impaired respiratory function.
authors.affiliation: Second Department of Surgery, Organ Regenerative Surgery, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Atushi
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Motohira
authors.initials: M
authors.lastname: Yoshida
authors.forename: Shungo
authors.initials: S
authors.lastname: Yukumi
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugishita
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishida
authors.forename: Satoshi
authors.initials: S
authors.lastname: Furuta
authors.forename: Kanji
authors.initials: K
authors.lastname: Kawachi