Small cell carcinoma (non-oat cell type) of the esophagus concomitant with invasive squamous cell carcinoma and carcinoma in situ. A case report

Abstract

A case of double primary invasive carcinoma of the esophagus, consisting of well-differentiated squamous cell carcinoma and non-oat cell small cell carcinoma without squamous differentiation, is presented. This is the first reported case of a double or multiple primary invasive carcinoma of the esophagus in which one component is small cell carcinoma (oat cell or non-oat cell). Furthermore, the mucosal epithelium around the non-oat cell small cell carcinoma revealed multiple dysplasia and carcinoma in situ. These lesions were definitely separated from the invasive carcinoma and from each other. The results suggest that pure non-oat cell small cell carcinoma of the esophagus without squamous differentiation is derived from the esophageal squamous epithelium, and is a variant of squamous cell carcinoma.

Basaloid squamous carcinoma of the oesophagus: a distinct neoplasm with multipotential differentiation

“…22 The pluripotential nature of this tumour led some authors to consideration of totipotential primitive cell origin, 21,23 or a variant of squamous cell carcinoma. 22,24 The similarity between small cell carcinoma and BSC, and their actual coexistence strongly suggest that the origin of both tumours may be the pluripotential stem cells of the oesophageal epithelium. Immunohistochemical study for neuroendocrine markers would always be satisfactory for distinction between the basaloid cells and small cell carcinoma, as in this study.…”

Squamous carcinoma of the oesophagus: histological criteria and their prognostic significance

“…Primary small cell tumours within the oesophagus have been divided into two histogenetic groups, an oat cell type believed to be of neuroendocrine origin, probably derived from argyrophil cells in the basal parts of the squamous epithelium (Tateishi et al, 1974), and a reserve cell type believed to be derived from undifferentiated cells (Briggs & Ibrahim, 1983;Sato et al, 1986). Failure of the nine tumours with small cell areas to stain with bombesin or calcitonin tentatively supports a reserve cell origin of these areas.…”

Synchronous primary adenocarcinoma and adenosquamous carcinoma of the esophagus

“…In the esophageal mucosa, widespread carcinomatous transformation has been observed [5,6,7,8] and multicentric invasive squamous cell carcinomas may develop [6,9]. Sato et al reported the case of a small cell carcinoma (non-oat-cell type) of the esophagus concomitant with invasive squamous cell carcinoma and carcinoma in situ, and concluded that it was reasonable to consider the three carcinomas as multicentric squamous cell carcinomas [10].…”

“…Because multiple malignant tumors and multicentric invasive carcinomas of the esophagus have been described [5,6,7,8,9,10], it is very important to study the entire organ for treatment planning. The evaluation of the whole esophageal mucosa after an incomplete esophagoscopy, as in our patient, requires further investigations.…”