title: Rapidly growing esophageal carcinosarcoma reduced by neoadjuvant radiotherapy alone.
abstract: Esophageal carcinosarcoma is a rare malignant neoplasm consisting of both carcinomatous and sarcomatous components. It is generally treated by surgery, radiotherapy and chemotherapy according to the protocols used for other esophageal cancers. However, the treatment of esophageal carcinosarcoma by radiotherapy alone before surgery has not been previously described. We report a patient with a rapidly growing esophageal carcinosarcoma that was efficiently reduced by neoadjuvant radiotherapy alone. A previously healthy 69-year-old man was admitted with dysphagia. Initial esophagogastroduodenoscopy (EGD) revealed a small nodular polypoid lesion of about 10 mm in the middle esophagus. A second EGD 1 month later showed that the tumor had expanded into a huge mass. A biopsy specimen revealed that the tumor comprised squamous cell carcinoma with spindle cell components, and the tumor was diagnosed as carcinosarcoma which was diagnosed as stage I (T1bN0M0). Due to renal dysfunction, the patient was treated with neoadjuvant radiotherapy (40 Gy) without chemotherapy. A third EGD 1 month later revealed remarkable tumor reduction. He then underwent total esophagectomy with regional lymph node dissection (pStage 0, pT1aN0M0). After surgical operation, the patient was followed up without adjuvant therapy. Whole body computed tomography revealed lung metastasis 14 months after surgery, and the patient died 2 months later. The neoadjuvant radiotherapy for esophageal carcinosarcoma was considered to have contributed to the subsequent surgery and his prolonged survival time. Thus, radiotherapy alone might be a suitable neoadjuvant therapy for esophageal carcinosarcomas.
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Naotaka
authors: N
authors: Ogasawara
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Yasuhiro
authors: Y
authors: Tamura
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Yasushi
authors: Y
authors: Funaki
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Yoshiharu
authors: Y
authors: Yamaguchi
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Akihiro
authors: A
authors: Shimozato
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Kenichiro
authors: K
authors: Yanamoto
authors: Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Emiko
authors: E
authors: Takahashi
authors: Department of Surgery, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Masahiko
authors: M
authors: Miyachi
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Makoto
authors: M
authors: Sasaki
authors: Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan.
authors: Kunio
authors: K
authors: Kasugai
keywords: Dysphagia; Gastrointestinal cancer; Malignant transformation; Squamous cell carcinoma; Treatment