-Case Reports-

A Case of Carcinosarcoma of the Esophagus Detected on Fluorodeoxyglucose Positron Emission Tomography

Takeshi Matsutani¹, Tsutomu Nomura¹, Nobutoshi Hagiwara¹, Hiroshi Yoshida², Tadashi Yokoyama², Hironori Katayama³, Masaru Hosone³, Akihisa Matsuda¹ and Eiji Uchida¹

¹Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Graduate School of Medicine
²Department of Surgery, Nippon Medical School Tama Nagayama Hospital
³Department of Pathology, Nippon Medical School Tama Nagayama Hospital

A 56-year-old woman who received surgery for left breast cancer 10 years previously underwent 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) for postoperative follow-up. FDG-PET revealed high uptake of tracer in the esophagogastric junction. A slightly elevated, lobular lesion was found in the lower third of the esophagus on upper gastrointestinal endoscopy. An endoscopic biopsy revealed squamous cell carcinoma. We performed thoracoscopic subtotal esophagectomy. Histopathological examination showed a polypoid spindle cell tumor arising from superficial squamous cell carcinoma. Immunohistochemically, the spindle cells were immunopositive for vimentin and AE1/AE3, and a carcinosarcoma of the esophagus was diagnosed. MIB-1 labeling indexes estimated by Ki-67 immunostaining showed that the proliferative rate of the sarcomatous component was markedly higher than that of the carcinomatous component. This is the rare reported case of esophageal carcinosarcoma that showed increased accumulation of tracer on FDG-PET.

J Nippon Med Sch 2014; 81: 401-405

Keywords
esophagus, carcinosarcoma, Ki-67, MIB-1 labeling index, positron emission tomography

Correspondence to
Takeshi Matsutani, MD, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
matsutani@nms.ac.jp

Received, May 20, 2014
Accepted, June 28, 2014