1/1925. Hodgkin's disease of the esophagus: report of a case. Most esophageal malignancies are either squamous carcinomas or adenocarcinomas arising in the background of Barrett's esophagus. We describe a case of an 85-yr-old woman in whom the diagnosis of esophageal malignancy was difficult to confirm despite its endoscopic appearance and previous biopsies. This case illustrates the difficulty in diagnosing Hodgkin's disease of the esophagus. Despite the rarity of this entity, if clinically indicated by symptoms, large, deep biopsies by rigid esophagoscopy should be considered. ( info) |
2/1925. Giant fibrovascular polyp of the esophagus: CT and MR findings. We present a case of giant fibrovascular polyp of the esophagus with predominant fat contents. Both computed tomography (CT) and magnetic resonance imaging (MRI) findings of this rare tumor are reported. The employment of CT and MRI in the presurgical evaluation of fibrovascular esophageal polyp is suggested. ( info) |
3/1925. Metastatic esophageal carcinoma to the orbit. PURPOSE: To report a case of esophageal adenocarcinoma and areas of gastric differentiation in the esophagus (barrett esophagus) metastatic to the orbit. methods: A 47-year-old man with a history of esophageal carcinoma developed turgescence around his left eye. He underwent a biopsy and histologic examination of a left orbital mass. RESULTS: Histopathology of the orbital tumor was consistent with metastatic adenocarcinoma from the esophagus. CONCLUSIONS: This metastatic adenocarcinoma to the orbit likely arose in barrett esophagus. ( info) |
4/1925. Advances in gastrointestinal endoscopy. endoscopy has a rapidly expanding role in diagnosis and management of gastrointestinal disease. ( info) |
5/1925. Pedunculated esophageal leiomyosarcoma: a case report. We report a case of esophageal leiomyosarcoma that possibly arose from the muscularis mucosae, thereby showing a particularly unusual appearance. A large polypoid intraluminal lesion in the distal esophagus was found on an endoscopic examination of a 68-year-old man with a 3-month history of dysphagia. Although the histological examination of biopsy specimens clearly revealed leiomyosarcoma, the absence of an exophytic component on computed tomography (CT) scan caused us to suspect that the tumor was carcinosarcoma. The tumor was resected by a subtotal esophagectomy. Microscopic evaluation revealed no involvement in the layer of the muscularis propria and no component of carcinoma. Clinical features of the pedunculated esophageal leiomyosarcoma shown in this case and three additional cases previously reported in the literature are reviewed. ( info) |
6/1925. Synovial sarcoma of the esophagus simulating achalasia. Synovial sarcoma is a rare malignancy occurring mainly in the extremities. Only seven cases have been described arising in the esophagus. All of them presented as a polypoid mass involving the upper third of the esophagus. A case of infiltrating synovial esophageal sarcoma simulating achalasia in a 63-year-old woman is reported. According to the literature, the location and the clinical pattern of this tumor are exceptional. The clinical features, pathologic findings, differential diagnosis, and management of this condition are discussed. ( info) |
7/1925. p53 gene mutation in 150 dissected lymph nodes in a patient with esophageal cancer. For thoracic esophageal cancer, we perform extended three field lymph node dissection, and have achieved nearly 50% of overall 5-year survival. However, patients sometimes develop lymph node recurrences in spite of having no lymph node metastases found by conventional histopathologic examination. In a patient with esophageal squamous cell carcinoma, we sequenced all the p53 cDNA translated regions (exon 2-10) of primary carcinoma, and confirmed one p53 nonsense mutation in exon 10. Then we extracted genomic dna from 150 surgically dissected lymph nodes from that patient, and performed polymerase chain reaction analysis (PCR-RFLP) to detect the same p53 mutation in the lymph nodes. PCR-RFLP analysis showed the same p53 mutation in six lymph nodes. One node was located along the right recurrent laryngeal nerve, where no positive nodes was identified by conventional histopathologic examination. The p53 mutational diagnosis of metastatic cancer may be useful in detecting minimal residual disease. ( info) |
8/1925. Squamous cell papillomatosis of esophagus following placement of a self-expanding metal stent. The esophageal self-expanding metal stent has gained widespread acceptance for the management of tracheoesophageal fistulas and the palliative management of malignant esophageal strictures. The complications associated with its use can be classified as either immediate or delayed. The most frequent delayed complications include tumor ingrowth, stent migration, reflux of gastric contents, bleeding, and perforation. This case report illustrates an otherwise unrecognized delayed complication of a self-expanding metal stent. Near complete ingrowth of the stent by squamous mucosal hyperplasia occurred within six weeks of the metal stent's placement. This finding supports the hypothesis that mucosal injury and regeneration underlies the etiology of esophageal squamous cell papilloma formation. ( info) |
9/1925. To B or not to B: is tylosis B truly benign? Two North American genealogies. Tylosis is a rare, autosomal dominant syndrome presenting with hyperkeratosis of the palms and soles of the feet. Two types have been identified. Late onset tylosis (type A) is reported to be associated with a high incidence of esophageal carcinoma, whereas early onset tylosis (type B) appears to be a benign disorder. This distinction has significant implications for surveillance and prognosis. We report two families exhibiting early onset type B tylosis, spanning five and seven generations, respectively, and believe these to be the first two extensive genealogies of tylosis type B reported in north america. They serve to verify the features of type B tylosis and its benign prognosis. The world literature is reviewed and clinical relevance is discussed. Recommendations for follow-up of afflicted individuals are proposed. ( info) |
10/1925. A case of advanced esophageal cancer showing a long-term complete response with chemotherapy with nedaplatin alone. We describe a case of advanced esophageal cancer treated successfully by chemotherapy with nedaplatin alone. A 60-year-old male with type 2 advanced esophageal cancer, which was located in the upper part of the esophagus and had invaded adjacent organs, was treated with nedaplatin 150 mg/body (100 mg/m2) given intravenously every 4 weeks from January 6, 1991. He achieved a partial response (PR) and was discharged in March 1991. Subsequently, he received nedaplatin 75 mg/body in an out-patient setting almost every month until August 1992. Toxicities were tolerable and included mild thrombocytopenia and nausea/vomiting. From serial evaluation in October 1993, the esophageal tumor was not observed. After 7 years since initial chemotherapy was administered, he still survives without the disease. ( info) |