Verrucous carcinoma of the esophagus - a case report and literature review.

Abstract:

BACKGROUND: Verrucous carcinoma of the esophagus is a rare disease leading to dysphagia, chest pain, and weight loss. The diagnosis is difficult because even repeated biopsies are often without tumor evidence. We present a patient with verrucous carcinoma of the esophagus and a literature review. CASE REPORT: A 64-year-old patient with dysphagia and sore throat received esophagogastroduodenoscopy illustrating segmental circumferential verrucous inflammation and Candida esophagitis in the middle part of the esophagus. Repeated mucosal biopsies revealed reactive hyperkeratosis of the squamous epithelium with minimal atypia but without ulcera, eosinophilic esophagitis, or suspicion of cancer. Mucosal infection with adenovirus, herpes simplex virus 1, human papilloma virus types, and cytomegaly virus was ruled out. Veruccous carcinoma was detected finally by endoscopic mucosal resection. The patient was successfully treated by esophageal resection. Tumor stage was G1, pT1b, pN0, L0, V0, Pn0, R0. CONCLUSION: The results suggest that macroscopic suspicion of verrucous esophageal carcinoma should lead to resections of larger tissue specimens by EMR to confirm the diagnosis. HINTERGRUND: Das verruköse Ösophaguskarzinom ist eine seltene Erkrankung, die zu Dysphagie, Brustschmerzen und Gewichtsverlust führen kann. Die Diagnose ist schwierig, da selbst wiederholte Biopsien negativ sein können. Wir stellen einen Patienten mit verrukösem Ösophaguskarzinom und eine Literaturübersicht vor. FALLBERICHT: Ein 64-jähriger Mann erhielt wegen Dysphagie und Sodbrennen eine Ösophagogastroduodenoskopie, die eine segmentale verruköse Entzündung und Soorinfektion im mittleren Ösophagus zeigte. Mehrmalige Biopsien ergaben eine reaktive Hyperkeratose des Plattenepithels mit minimalen Epithelatypien ohne Hinweise auf Ulzera, eosinophile Ösophagitis oder Karzinom. Mukosainfektionen mit Adenoviren, Herpes simplex Viren, Humanem Papilloma Virus und Cytomegalie Viren wurden ausgeschlossen. Das verruköse Karzinom wurde schließlich durch eine endoskopische Mukosaresektion (EMR) festgestellt. Der Patient wurde erfolgreich ösophagektomiert. Das Tumorstadium war G1, pT1b, pN0, L0, V0, Pn0, R0. SCHLUSSFOLGERUNG: Die Ergebnisse zeigen, dass bei endoskopischem V. a. ein verruköses Ösophaguskarzinom größere Gewebeentnahmen zur Sicherung der Diagnose erforderlich sind.

journal_name

Z Gastroenterol

authors

Frieling T,Kreysel C,Blank M,Müller D,Euler P,Melchior I,Wullstein C,Hemmerlein B

doi

10.1055/a-1231-5820

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

971-974

issue

10

eissn

0044-2771

issn

1439-7803

journal_volume

58

pub_type

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