巨大な縦隔腫瘍にて再発した食道のいわゆる癌肉腫の1例

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  • A CASE OF SO-CALLED CARCINOSARCOMA OF THE ESOPHAGUS WITH RECURRENCE AS GIANT MEDIASTINAL TUMOR

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So-called carcinosarcoma of the esophagus is frequently polypoid, and can be easily detected even when there is little invasion, but the prognosis is poor relative to the depth of invasion. This tumor mainly recurs as squamous cell carcinoma in the lymph nodes. A patient presented here underwent a curative resection and postoperative combination chemotherapy, but had a recurrence as rapidly growing giant mediastinal tumor. A 56-year-old man was seen at the hospital because of chest discomfort. A giant polypoid tumor of the esophagus was found and he was admitted to the hospital. Biopsy revealed spindle-shaped cells, and a diagnosis of carcinosarcoma was established. The excised specimen was a polypoid tumor with a pedicle (8.1×5.2×3.9cm). Histological examination revealed a mixture of spindle-shaped cells and squamous cell carcinoma with transitoneal regions between them. Histologically, the carcinoma was mp, ly(+), v0, n(-), ow(-), aw(-), p10, stage I. Three-drug combination chemotherapy (CDDP + 5FU + leucovorin) was started on the 4th month postoperatively, but on the 9th month a giant tumor developed in the posterior mediastinum and eventually protruded into he right thoracic cavity in association with bleeding. This was considered to be a rare type of recurrence.

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