Navigating through unusual — esophageal spindle cell carcinoma
, 2, 1, 1, 1
Abstract
Introduction. Esophageal spindle cell carcinoma is a rare neoplasm of esophagus with unique presentation having varying clinical, histopathological, radiological, and molecular features. It has dual nature of histology consisting of epithelial and sarcomatous components present within the tumor cells. High recurrences are noted in lymph nodes following surgery. Here we report an unusual case of spindle cell carcinoma of middle thoracic Esophagus treated with radiation and chemotherapy.
Case report. A 47-years-old adult male presented to Radiation Oncology outpatient department with complains of progressive dysphagia of 2-month duration, associated with hoarseness of voice and weight loss. Contrast enhanced computed tomography showed esophageal thickening and growth in the middle thoracic region. Histopathological examination of growth confirmed esophageal spindle cell carcinoma with vimentin and cytokeratin positivity. Patient underwent external beam radiation therapy followed by salvage oral metronomic chemotherapy. After 2-months of oral chemotherapy, patient lost to follow up.
Conclusions. Spindle cell carcinoma is uncommon malignancy of esophagus, owing to their dual nature of histology within tumor tissue. Patients tend to present with early symptoms. Surgery remains important intervention in management of spindle cell carcinoma. However, lack of uniform consensus underscores the complete management of these uncommon neoplasms. Through this case report and short review, we aim to contribute in establishing uniform consensus.
Keywords: esophagusmetronomic chemotherapyradiation therapyspindle cell carcinoma
References
- Yoshimoto T, Kobayashi S, Kanetaka K, et al. Preoperative chemotherapy with docetaxel, cisplatin, and 5-fluorouracil for locally advanced esophageal carcinosarcoma: a case report and review of the literature. Surg Case Rep. 2018; 4(1): 18.
- Alamassi M, Arabi EY, Arabi H, et al. A rare case of carcino-sarcoma of the esophagus with huge intrathoracic metastasis. J Surg Case Rep. 2024; 2024(4): rjae236.
- Yoneda A, Miyoshi T, Hida T, et al. Carcinosarcoma of the Thoracic Esophagus That Presented as Focal Ulcerative Lesion. Case Rep Gastroenterol. 2021; 15(3): 795–800.
- Raza MA, Mazzara PF. Sarcomatoid carcinoma of esophagus. Arch Pathol Lab Med. 2011; 135(7): 945–948.
- Hu B, Zhao K, Yang Y, et al. Investigating esophageal sarcomatoid carcinoma and its comparison with esophageal squamous cell carcinoma on clinicopathological characteristics, prognosis, and radiomics features: a retrospective study. Front Oncol. 2024; 14: 1398982.
- Jain V, Varshney P, Aggarwal D, et al. Carcinosarcoma of the Esophagus-A Diagnostic Challenge. Ochsner J. 2023; 23(3): 243–247.
- Li P, Li Y, Zhang C, et al. Clinicopathological and Prognostic Characteristics of Esophageal Spindle Cell Squamous Cell Carcinoma: An Analysis of 43 Patients in a Single Center. Front Oncol. 2021; 11: 564270.
- Zhang B, Xiao Q, Yang D, et al. Spindle cell carcinoma of the esophagus: A multicenter analysis in comparison with typical squamous cell carcinoma. Medicine (Baltimore). 2016; 95(37): e4768.
- Pisters PWT, O'Sullivan B. Soft Tissue Sarcomas. In: Kufe DW, Pollock RE, Weichselbaum RR. ed. Holland-Frei Cancer Medicine. 6th edition. BC Decker, Hamilton (ON) 2023.
- Shen J, Lu K, Liu F, et al. Clinicopathologic features and surgical treatment prognosis of esophageal carcinosarcoma. Front Oncol. 2024; 14: 1387611.
- Wang L, Lin Y, Long H, et al. Esophageal carcinosarcoma: a unique entity with better prognosis. Ann Surg Oncol. 2013; 20(3): 997–1004.
- Cavallin F, Scarpa M, Alfieri R, et al. Esophageal carcinosarcoma: management and prognosis at a single Italian series. Anticancer Res. 2014; 34(12): 7455–7459.
- Hashimoto M, Kitagami H, Niwa H, et al. Prognosis and prognostic factors of esophageal spindle cell carcinoma treated by esophagectomy: a retrospective single-institution analysis. Esophagus. 2019; 16(3): 292–299.
- Chen S, Shi Yu, Lu Z, et al. Esophageal Carcinosarcoma: Analysis of Clinical Features and Prognosis of 24 Cases and a Literature Review. Cancer Control. 2021; 28: 10732748211004886.
- Yang S, Wang W, Bi N, et al. Intensity modulated radiotherapy might be effective for locally advanced esophageal carcinosarcoma: A single center's experience and review of literature. Medicine (Baltimore). 2022; 101(42): e31215.
- Czito BG, Palta M, Willett CG. Esohageal Cancer. In: Halperin EC, Wazer DE, Perez CA, Brady LW. ed. Principles and practice of radiation oncology. 7th ed. Wolters Kluwer, Philadelphia 2018: 1206–1243.
- R P, Paul D, Dhankhar R, et al. MALIGNANT TRACHEO-ESOPHAGEAL FISTULA IN ADVANCED ESOPHAGEAL CANCER: REPORT OF TWO CASES. INDIAN JOURNAL OF APPLIED RESEARCH. 2024: 66–67.
- Kobayashi D, Koike M, Kodera Y, et al. Carcinosarcoma of the esophagus treated with chemoradiotherapy: report of four cases. Esophagus. 2010; 7(2): 119–125.
- Fu Y, Wang PP, He Du, et al. Major pathological response after neoadjuvant immunotherapy in esophageal spindle cell carcinoma: A case report. Thorac Cancer. 2021; 12(8): 1234–1239.