Preoperative chemoradiotherapy and surgery for locally advanced esophageal basaloid squamous carcinoma: report of successful

Abstract

A 58-year-old Japanese man complained of dysphagia, and esophagography and endoscopy showed a 7.5-cm-long protruding tumor in his middle esophagus. Biopsy diagnosed the lesion as basaloid squamous carcinoma. We assessed the tumor as T3N0M0 stage II. Preoperative chemoradiotherapy was started, consisting of 3 weeks of intravenous chemotherapy with 10 mg/day cisplatin and 750 mg/day 5-fluorouracil and concurrent total 45-Gy external irradiation applied to the tumor. We evaluated the effectiveness as a partial response and performed curative resection with radical esophagectomy 23 days after the completion of chemoradiotherapy. The pathological findings showed necrosis and degeneration over two-thirds of the tumor. Postoperatively, he returned to physical labor and has had no evidence of recurrence for 5 years. Although basaloid squamous carcinoma of the esophagus is associated with poor prognosis because of its highly malignant potential, preoperative chemoradiotherapy followed by radical esophagectomy may allow for the possibility of improving the prognosis of a fatal process.

A clinicopathological study of basaloid squamous carcinoma of the esophagus

“…Previous studies have reported that patients with early-stage BSC and those who undergo curative resection can be expected to have outcomes similar to those of patients with typical squamous cell carcinoma (SCC) of the esophagus [6,7]. Some of these patients respond to chemotherapy [4,5,8]. Early detection and multidisciplinary therapy are essential for improved outcomes.…”

Carcinoma basalóide escamoso: uma forma rara e agressiva de câncer do esôfago e revisão da literatura

“…O paciente apresentou acentuada queda do estado geral e evoluiu para óbito com quadro de melena, quatro meses após o diagnóstico. , o carcinoma basalóide escamoso é mais freqüente em homens com idade acima de 40 anos e no terço médio do esôfago torácico 2,4,5,13 . Tais características sobrepõem-se às observadas no presente caso, exceto para o local da lesão, que estava situada no terço distal do esôfago, coincidindo com o referido por Albuquerque et al (2006) .…”

“…Autores japoneses preconizam quimioterapia com 5-Fluoracil e cisplatina para os tumores localmente avançados, sem metástases à distância 4,7 . Esta conduta visa reduzir as dimensões da lesão primária, de modo a viabilizar a realização da esofagectomia associada a linfadenectomia em três campos: cervical, torácico e abdominal, com razoável índice de sobrevida.…”

“…O carcinoma basalóide escamoso (CBE) é uma variante incomum do carcinoma de células escamosas do esôfago (CEC), com características clínicas próprias, sendo a alta agressividade biológica e o mau prognóstico os atributos de maior destaque 2,4,10 . Este tipo de neoplasia ocorre com maior freqüência no trato aerodigestivo superior, tendo como sítios primários preferenciais a cavidade oral, faringe, laringe, seio piriforme e traquéia 5,8,14 .…”