1/160. Esophageal undifferentiated carcinoma displaying marked chondroid differentiation at metastatic foci.A report of an unusual esophageal tumor in an 81-year-old man is presented. The primary tumor was diagnosed as undifferentiated carcinoma at biopsy and had disappeared after irradiation treatment. However, multiple metastases were noted in the brain, lungs, kidneys, adrenals and spleen at autopsy. Histologically, metastases showed marked cartilaginous metaplasia as demonstrated by light microscopy, histochemical and immunohistochemical studies, although the initial biopsy sample did not possess chondroid matrix. Furthermore, an apparent transition could be traced from carcinomatous to chondroid cells, suggesting that the chondroid cells were derived from carcinoma cells. The carcinomatous area partially showed both squamous and glandular differentiation, although they were poorly differentiated. A retrospective immunohistochemical study that used a panel of antibodies suggested a phenotypic relevance between primary and metastatic tumors.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
2/160. Esophageal carcinoma with spread to mesenteric and iliac lymph nodes.carcinoma of the esophagus can metastasize to unusual sites. We report a patient with esophageal carcinoma with retrograde spread to the mesenteric and iliac lymph nodes from celiac nodes, demonstrated by magnetic resonance imaging and confirmed by FNAC.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
3/160. Primary small cell carcinoma of the esophagus with achalasia in a patient in whom pro-gastrin-releasing peptide and neuron-specific enolase levels reflected the clinical course during chemotherapy.We report a case of primary small cell carcinoma of the esophagus in a patient with achalasia in whom pro-gastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) levels were measured. Although chemotherapy markedly reduced the size of the primary tumor and lymph node metastases, it had no effect on liver metastases. The tumor marker levels decreased after chemotherapy as the primary tumor and lymph node metastases decreased in size, and they increased as the liver metastases enlarged. However, there was a discrepancy between the levels of ProGRP and NSE during the patient's clinical course. We demonstrate the usefulness of measuring ProGRP and NSE levels to assess the effect of chemotherapy in patients with esophageal small cell carcinoma.- - - - - - - - - - ranking = 13.811095686983keywords = size (Clic here for more details about this article) |
4/160. Multiple primary cancers of the esophagus and thyroid gland.The occurrence of multiple primary cancers in the aerodigestive tract is a well known phenomenon that has been explained by the concept of 'field carcinogenesis'. Metachronous or synchronous esophageal cancer has usually been identified in patients with head and neck cancer, gastric cancer or colon cancer. The incidence of multiple primary cancers of the esophagus and thyroid gland is very low. We treated four patients with synchronous cancers of the cervical esophagus and the thyroid gland. Histologically, all of the esophageal cancers were squamous cell carcinomas. Thyroid cancers were evaluated as papillary carcinoma or follicular carcinoma. Both the esophageal cancer and the thyroid cancer frequently metastasized to lymph nodes. All patients had multiple lymph nodes metastasis from the esophageal or the thyroid cancer. In one patient, both the esophageal and the thyroid cancers were detected in the same lymph node. Three of four patients died from recurrence of esophageal cancer. The prognosis of these patients was poor. In the treatment of esophageal carcinoma, cancers of other organs including the thyroid gland should be carefully investigated.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
5/160. Primary squamous cell carcinoma of the breast presenting as a breast abscess.Primary squamous cell carcinoma (SCC) of the breast is a very rare neoplasm, with only 75 cases reported in the English literature. Herein, we report four new cases and discuss the diagnostic and therapeutic challenges of this unusual tumor in a retrospective review of all cases of SCC of the breast at our institution from 1990 to 1998. Four patients with breast SCC were identified, with a mean age of 70 years. Two patients with "pure" SCC (no features of ductal carcinoma) were initially treated for breast abscess. Two other patients with features of both SCC and ductal carcinoma had skin erythema associated with an underlying mass, and infectious etiology was considered in each case. Mean tumor size was 4.9 cm. Both patients with pure SCC underwent extensive evaluation for primary tumors at other sites. Two patients developed early systemic metastasis. SCC of the breast is often diagnosed at an advanced stage and may be confused with breast abscess. For this reason, breast biopsy should be considered in cases of breast abscess. Treatment of primary SCC of the breast is similar to that of more common types of breast cancer (i.e., breast conservation is possible and lymph node dissection is recommended). Because metastasis to the breast from other primary tumor sites has been reported (lung, cervix, skin, and esophagus), patients with pure SCC should undergo evaluation to exclude this possibility.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
6/160. Endoscopic resection of two granular cell tumours of the oesophagus.Granular cell tumour of the oesophagus is rare and usually single. It is diagnosed by endoscopic appearance, results of endosonography, and histological examination of biopsy specimens. Although histological examination is required for diagnosis, it is difficult occasionally to obtain tumour samples by forceps because granular cell tumour is usually located in the submucosal layer. We report the case of a Japanese man with two granular cell tumours of the oesophagus. One lesion was diagnosed as a granular cell tumour by histological examination of a biopsy specimen, but the other was not. Endoscopic resection was performed to obtain the diagnosis and treat the lesions since some granular cell tumours are potentially malignant. Both tumours were completely resected endoscopically, and the diagnosis of granular cell tumour could be established by histological examination of resected tissue. Endoscopic resection is thus useful in the diagnosis and treatment of granular cell tumour of the oesophagus.- - - - - - - - - - ranking = 1keywords = sample (Clic here for more details about this article) |
7/160. Photodynamic therapy as a treatment for esophageal squamous cell carcinoma in a dog.Intrathoracic esophageal squamous cell carcinoma was diagnosed by endoscopy in an 11-year-old, castrated male Labrador retriever with signs of regurgitation and weight loss. Photodynamic therapy with photofrin was administered three times under endoscopic guidance over a two-month period. A partial response to photodynamic therapy was supported by a reduction in tumor size (noted on serial endoscopic examinations) and by a return to oral alimentation. The dog was euthanized due to recurrent regurgitation and aspiration pneumonia nine months after the onset of therapy. Necropsy revealed marked local invasiveness and regional lymph node metastasis of the esophageal squamous cell carcinoma in addition to pneumonia. The application of photodynamic therapy in the treatment of canine esophageal squamous cell carcinoma is discussed and compared with the human literature.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
8/160. Esophageal cancer: an unusual endoscopic appearance and presentation.Esophageal cancer in advanced stages grows to occlude the esophageal lumen; presenting symptoms include dysphagia and weight loss. Esophageal cancer rarely grows to occupy a narrow column of the esophagus or manifests neurologic symptoms. We report the case of a 58-year-old man with a history of tobacco and alcohol abuse and chronic obstructive airway disease who presented with headaches, left-sided weakness, unsteady gait, and weight loss. physical examination showed left-sided weakness. Computed tomographic scan of the brain and chest revealed, respectively, a right frontoparietal mass and a tumor mass in the distal esophagus. The patient's weakness and headaches improved after treatment with dexamethasone and craniotomy with partial enucleation of the brain lesion. An esophagogastroduodenoscopy revealed a large, elongated mass in the esophagus. Pathologic analyses of biopsies of the esophageal mass showed mixed adenosquamous carcinoma. The brain mass histology showed poorly differentiated carcinoma. Several weeks after craniotomy, the patient developed respiratory failure and died. While it appears that the esophageal cancer metastasized to the brain, there is the possibility of other undetected primary tumor with metastasis to the brain. Nonetheless, the endoscopic appearance and clinical presentation of this case are unusual and noteworthy.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
9/160. Fatal hemorrhage complicating carcinoma of the esophagus. Report of four cases.Four cases of esophageal carcinoma complicated by fatal hemorrhage are reported. All four patients had recently completed radiation therapy. An aortoesophageal fistula was present in two cases; fibrinoid necrosis of the esophageal arteries was present in the other two. The esophageal tumor was localized in two cases and had disappeared in one case. In one patient it had metastasized widely. Ninety-nine other reports of esophageal cancer and fatal hemorrhage are reviewed from the literature. Aortoesophageal fistula was the cause of hemorrhage in 78 cases. Occlusion of the vasa vasorum by thrombosis, inflammation, neoplastic cells or radiation injury appears to be the cause of aortic necrosis and fistula formation. Prompt surgical approach, if possible, should be used to control hemorrhage, as the primary tumor may be localized to the esophagus only.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
10/160. A case of esophageal carcinoma surgically treated after discontinuance of the simultaneous application of radiotherapy and chemotherapy with low doses of CDDP and 5-FU.The patient, a 69-year-old man with esophageal cancer, had a type 2 tumor in the Mt region, accompanied with an ulcer measuring 12 cm in the major axis. In addition, lymph node metastasis, approximately 5x4 cm, was observed in the lesser curvature of the stomach. The clinical stage of the lesion was T3N1M0 (stage III), and simultaneous therapy combining radiotherapy (2 Gy/day) with chemotherapy employing CDDP (6 mg/day) and 5-FU (300 mg/day) was started on October 21, 1996. During treatment, tumor invasion into the gastric walls from lymph node metastasis was observed on endoscopy, and radiotherapy was discontinued at a total dose of 40 Gy to avoid the possibility of bleeding. Surgery was performed on January 8, 1997. Although tumor invasion from lymph node metastasis in the lesser curvature of the stomach was observed in the pancreas, no remaining cancer cells were noted in the primary nest and metastasized lymph node, suggesting the usefulness of the simultaneous combined therapy.- - - - - - - - - - ranking = 6.9055478434917keywords = size (Clic here for more details about this article) |
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