術前化学療法を行った後の術後病理で診断された癌肉腫成分を含む食道癌の2 例

Case 1, a 73-year-old man who was given a diagnosis of esophageal cancer (cT4N2M0, Stage IV). An endoscopic biopsy specimen revealed squamous cell carcinoma. The patient underwent esophagectomy after two courses of neoadjuvant chemotherapy. Pathological analysis revealed adenosquamous carcinoma and sarcomatoid components. A slight effect of neoadjuvant chemotherapy was observed, with a response of Grade 1a, and the pathological diagnosis was pT3N2M0, Stage III. He died four months after the operation due to metastatic liver cancer. Case 2, a 68-year-old man given a diagnosis of esophageal cancer (cT2N3M0, Stage III). An endoscopic biopsy specimen revealed squamous cell carcinoma, and he underwent esophagectomy after two courses of neoadjuvant chemotherapy. Pathological analysis revealed squamous cell carcinoma and sarcomatoid components. A slight effect of neoadjuvant chemotherapy was observed, with a response of Grade 1a, and the pathological diagnosis was pT1bN0M0, Stage I. There has been no recurrence for four years after the operation. Both clinical tumor responses of our two patients were stable disease, and the pathological responses were Grade 1a. There is no evidence regarding the effectiveness of neoadjuvant chemotherapy for esophageal carcinosarcoma in the literature. In addition, preoperative diagnosis of carcinosarcoma is often difficult. In case the gastrointestinal endoscopy shows unique findings of carcinosarcoma, caution should be exercised to ensure accurate diagnosis. We should collect cases like these to study the effectiveness of neoadjuvant chemotherapy for esophageal carcinosarcoma.