Korean J Gastroenterol.  2018 Nov;72(5):258-261. 10.4166/kjg.2018.72.5.258.

Esophageal Basaloid Squamous Carcinoma Treated by Endoscopic Resection and Radiation

• Kim SB
• Lee SH
• Jeong DE
• Kim KO
• Gu MJ

• KMID: 2426867
• DOI: http://doi.org/10.4166/kjg.2018.72.5.258

Abstract

Esophageal basaloid squamous carcinoma (BSC) is a rare, aggressive variant of squamous cell carcinoma. BSC is usually diagnosed in advanced stage and its prognosis is relatively poor. A 59-year-old male with subepithelial lesion of the esophagus that was incidentally discovered during health promotion examination was referred to our hospital. Esophagogastroduodenoscopy showed a 10-mm bulging mucosa with an intact surface at 34 cm from incisor teeth. Endoscopic ultrasonography revealed a smooth margined homogenous hypoechoic lesion, measuring 11.3×3.9 mm with a submucosal layer of origin. The patient underwent endoscopic mucosal resection of the subepithelial lesion. Pathologic examination of the resected specimen revealed BSC with involvement of vertical margin by tumor. The patient then underwent radiotherapy, and is doing well without recurrence for 35 months. We report a case of esophageal BSC confined to submucosal layer successfully treated with endoscopic resection followed by radiation.

Keyword

Basaloid squamous carcinoma; Subepithelial lesion; Esophagus; Endoscopic mucosal resection; Radiation

MeSH Terms

Carcinoma, Squamous Cell*
Endoscopy, Digestive System
Endosonography
Esophagus
Health Promotion
Humans
Incisor
Male
Middle Aged
Mucous Membrane
Prognosis
Radiotherapy
Recurrence
Tooth

Figure

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  Fig. 1 Esophagogastroduodenoscopy at admission. A 10 mm sized bulging mucosa with an intact surface at 34 cm from incisor teeth was noted.

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  Fig. 2 Endoscopic ultrasonography. A smooth margined homogenous hypoechoic lesion measuring 11.3×3.9 mm in size with a submucosal layer of origin was observed (white arrow).

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  Fig. 3 Lifting of the subepithelial lesion of the esophagus with combination of saline solution, diluted epinephrine, and methylene blue (A), and post endoscopic mucosal resection result (B).

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  Fig. 4 Histologic examination of resected specimen. The tissue showed small crowded cells with scant cytoplasm tumor cells with peripheral palisading (black arrow) (A; H&E, ×40) and central necrosis (black arrow) (B; H&E, ×200) in the submucosal layer of esophagus and involvement of vertical resection margin by tumor was noted (C; H&E, ×100).

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  Fig. 5 Follow-up esophagogastroduodenoscopy at 35 months from the initial treatment showed ulcer scar at 34 cm from incisor teeth.

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