Pseudosarcoma of the oesophagus

Abstract

this appointment, but was admitted to my ward with severe haematemesis the following year. In view of these series of haematemeses and negative radiographs, a laparotomy was carried out. At operation the gastro-enterostomy was rotated upon itself causing engorgement of the vessels. The constriction at the duodenojejunal junction was rectified by removing a thick fibrous band and enlarging the lumen. It was then realized that the gastro-enterostomy could now serve no useful purpose. It was, therefore, undone and the parts restored to normal. Careful examination failed to show any evidence of a gastric ulcer. The haematemeses were probably due to engorgement of the vessels leading to superficial erosions. Subsequent fibrescopic examination showed no pathology and he has remained fit and well ever since. There were 7 cases for which a duodenojejunostomy was performed (Table ZZ). T h e y quite fortuitously did somewhat better. Only I required a subsequent operation and this was for a n osteitis of one of his metatarsal bones at the age of 3 years.Case 8.-The youngest in the series is E. M., who also had a duodenojejunostomy and proved of special interest. She was admitted in a moribund state at the age of 5 days. She was collapsed, cyanosed, with a high-pitched cry, and was at first thought to be suffering from some cerebral condition. A radiograph, carried out later more by chance than clinical acumen, showed a duodenal atresia. Following resuscitation, a laparotomy revealed this obstruction at the junction of the second and third parts of the duodenum so a duodenojejunostomy was performed. As the abdominal wound was being sutured, she had cardiac arrest. A thoracotomy and cardiac massage were performed and it was 3 minutes before spontaneous cardiac contractions returned. Following this she made a rapid and complete recovery. Her E.C.G. is normal, chest radiograph is normal, and the barium meal shows a normally functioning duodenojejunostomy (Fig. 8).Probably the most gratifying feature is that the survivors from this congenital abnormality are all perfectly normal individuals and the type of operation done does not seem to make much difference (Fig. 9).A NUMBER of cases, totalling just over 30, of turnours termed 'pseudosarcomas of the oesophagus' have been reported in the literature and the majority have been treated by excision of the oesophagus; the subsequent history of our personal case confirms the advisability of this major procedure. CASE REPORTA male patient, aged 57, gave a history of having had pain for a month in the epigastrium, occurring immediately after eating solid food; taking fluids did not cause any pain. He had one episode of vomiting 'coffee-ground' material I week before his admission.On examination, the only positive clinical finding was evidence of a mild degree of loss of weight. A bariumswallow radiograph (Fig. I) revealed a large intraluminary filling defect with a nodular outline in the lower third of the oesophagus, causing no gross obstruction but occupying a length of 4-5 in. Oesoph...

Carcinosarcoma and Pseudosarcoma of the Esophagus: Two Names, One Disease—Comprehensive Review of the Literature

“…At present 56 pseudosarcomas [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] and 127 carcinosarcomas (including a personal observation) [1, have been reported in the literature. Men comprised 82.6% and 80.4%, respectively, with the male/female ratios 4.7:1.0 and 4.1:1.0, respectively.…”

Squamous cell carcinoma with sarcomatoid stroma

“…Postmortem examination revealed widespread metastases with both carcinomatous and sarcomatous elements. Their view is supported by a similar case report by Hughes and Cruikshank [6]. These studies show that it is difficult to predict accurately the benign or malignant potential of the stromal component.…”

Carcinoma of the oesophagus with spindle cell features

“…1965). These tumours were said to behave less aggressively than carcinosarcoma and an optimistic approach to their surgical management was encouraged (Hughes & Cruikshank 1969, Razzuk et al 1971, Shields, Eilbert & Battifora 1972, Enrile et al 1973. The term pseudosarcoma was suggested for these tumours because of their similarity to the well-described pseudosarcoma of the mouth, fauces and larynx (Lane 1957, Goellner, Devine & Weiland 1973.…”