Hypertrophic pulmonary osteoarthropathy with esophageal sarcomatoid carcinoma: a case report

Abstract

Hypertrophic pulmonary osteoarthropathy (HPOA), mainly manifested clubbing, is rare in patients with esophageal sarcomatoid carcinoma. We herein describe a 48-year-old Chinese man whose advanced sarcomatoid carcinoma was diagnosed while examining his symptoms of HPOA. The patient had no opportunity of surgery after surgical evaluation. Chemoradiation, including 5 cycles of chemotherapy (Paclitaxel liposome 60 mg day 1 and nedaplatin 30 mg day 1, q1w) and 6MV-X/VMAT-95%PGTV 59.92 Gy/2.14 Gy/28 F and 95%PTV 50.4 Gy/1.8 Gy/28 F, and subsequent 6 cycles of chemotherapy (paclitaxel liposome 210 mg day 1 and nedaplatin 50 mg day 1, 60 mg day 2, q3w) shrank the tumor and the condition of the patient became stable without clubbing remission or exacerbation. No medical case report found in a PubMed search in the indexed English-language literature in the past 20 years, though there are some reports of HPOA combined with other pathologic types of esophageal carcinoma. The patient's condition was effectively controlled by chemotherapy and radiotherapy and showed stable disease. However, the five-year survival rate of advanced esophageal carcinoma patients is very low with low life quality, and the adverse reactions also contribute to low life quality. The purpose of this report is to present the feature and our treatment for primary esophageal sarcomatoid carcinoma with HPOA, which could be helpful for further understanding of the disease and clinical decision making. Moreover, this article also reviews esophageal carcinoma with HPOA and sarcomatoid carcinoma in the esophagus. We look forward to the breakthrough of immunotherapy and molecular targeting therapy to improve the situation.

A Case of Primary Esophageal Sarcomatoid Carcinoma Detected by 18F-FDG PET/CT

“…Only few literature have reported the imaging appearance of primary esophageal sarcomatoid carcinoma before. 7,8 In this case, the esophageal sarcomatoid carcinoma represents a large soft tissue mass with high 18 F-FDG uptake on 18 F-FDG PET/CT. However, the 18 F-FDG PET/CT findings of esophageal sarcomatoid carcinoma are similar to part of esophageal squamous carcinoma, leiomyosarcoma, or neuroendocrine carcinoma, [10][11][12] which are difficult to distinguish.…”

“…However, none of these clinical symptoms are specific, so as imaging findings. Only few literature have reported the imaging appearance of primary esophageal sarcomatoid carcinoma before 7,8 . In this case, the esophageal sarcomatoid carcinoma represents a large soft tissue mass with high 18 F-FDG uptake on 18 F-FDG PET/CT.…”

“…[1][2][3][4][5][6] The most common clinical presentation of esophageal sarcomatoid carcinoma is dysphagia, chest pain, or fever. [6][7][8][9] However, none of these clinical symptoms are specific, so as imaging findings. Only few literature have reported the imaging appearance of primary esophageal sarcomatoid carcinoma before.…”

“…Primary sarcomatoid carcinoma of the esophagus is rare, accounting for approximately 2% of esophageal carcinomas 1–6 . The most common clinical presentation of esophageal sarcomatoid carcinoma is dysphagia, chest pain, or fever 6–9 . However, none of these clinical symptoms are specific, so as imaging findings.…”