Multiple carcinosarcomas of the esophagus and stomach

Xu,Feng; Zou,Wen‑Bin; Li,Xiao‑Ping; Xu,Yue‑Mei; Qi,Xu‑Fei; Hu,Liang‑Hao; Li,Zhao-Shen; Yao,Ding‑Kang

doi:10.3892/ol.2012.1095

Multiple carcinosarcomas of the esophagus and stomach

Authors:
- Feng Xu
- Wen‑Bin Zou
- Xiao‑Ping Li
- Yue‑Mei Xu
- Xu‑Fei Qi
- Liang‑Hao Hu
- Zhao-Shen Li
- Ding‑Kang Yao
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Affiliations: Department of Gastroenterology, Yinzhou People's Hospital, Ningbo, Zhejiang 315040, P.R. China, Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, P.R. China, Department of Gastroenterology, Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P.R. China
Published online on: December 28, 2012 https://doi.org/10.3892/ol.2012.1095
Pages: 1017-1021

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Abstract

Carcinosarcoma is an uncommon biphasic malignant neoplasm consisting of both carcinomatous and sarcomatous components. We report a case of an 84‑year‑old male with multiple carcinosarcomas occurring in the esophagus and stomach. Endoscopically, a bulky pedunculated polypoid lesion was observed in the middle of the esophagus and a huge discoid lesion in the lesser curvature. The patient received esophageal endoscopic mucosal resection, and the specimen measured 4x2.5x1.5 cm. Microscopically, the esophageal tumor consisted of several polymorphic spindle cells mixed with squamous cells, while the gastric biopsies revealed carcinomatous cells with evident abnormal karyokinesis and polymorphous spindle cells. Immunohistochemically, the resected tumor stained positively for the epithelial markers, epithelial membrane antigen (EMA) and cytokeratin 19 (CK 19), and the mesenchymal markers, smooth muscle actin (SMA) and vimentin. The gastric lesion stained positively for CK AE1/AE3, actin and vimentin, but was negative for EMA. Both lesions were positive for neuron specific enolase (NSE), demonstrating neuroendocrine differentiation. The patient succumbed seven months after being discharged from hospital. To our knowledge, this is the first case in the literature that describes multiple carcinosarcomas arising from the esophagus and stomach. A review of the available literature is also presented.

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