[Resection of thoracic esophageal neoplasms--esophageal neoplasms of Ei stage].
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Esophageal neoplasms were diagnosed in 8 of 49,229 dogs seen over the last 11 years at the Veterinary Medical Teaching Hospital of the University of California at Davis. The neoplasms were primary in 2 dogs and metastatic to the esophagus in 6 dogs, with thyroid carcinoma being the most common site of the primary tumor. The most common clinical signs were regurgitation, dysphagia, weight loss, development of neck masses, and respiratory difficulties. It was concluded that the clinical signs often can be misleading. The interpretation of survey radiographs, barium contrast studies, or fluoroscopic studies often provide the initial data base. The final diagnosis requires histologic examination. Retention of air in the esophagus (with or without esophageal displacement) and motor dysfunction (with or without gross morphologic changes) are the most important criteria for radiographic diagnosis.
The radiographic appearance of 16 uncommon primary esophageal tumors (4 adenoid cystic carcinomas, 3 adenoacanthomas, 4 small cell carcinomas, 2 adenopapillary carcinomas, adenocarcinoma, mucoepidermoid carcinoma and malignant melanoma), is presented. These tumors were found in a retrospective study of 270 esophageal neoplasms. Sufficient radiographic, histologic and clinical data was available to substantiate primary esophageal origin of the tumors. Cylindromas tender to have a smooth surface and either funneled or polypoid appearance. None of the tumors, however, had radiographic appearance readily distinguishable from variable patterns of the common esophageal carcinomas. The age and sex distribution, location as well as prognosis of the rate adenocarcinomas appear to be similar to squamous cell carcinomas. The small cell carcinomas of the esophagus only had an average prognosis of 4 months. The x-ray examination was of little value in predicting local tumor spread, mediastinal metastases or prognosis.
The cancer procoagulant (CP) activity has been evaluated in homogenates of stomach and esophagus cancer tissues and in patients serum. Activity of CP in homogenates of stomach and esophagus cancer tissues as well as in serum of examined cancer patients were statistically higher than in the control group. The data indicate that estimation of CP activity in the neoplasmic tissues homogenates and in serum may be suggested as an new biochemical marker of cancer process useful in oncological diagnosis.
Human esophageal neoplasms were studied in comparison to normal, uninvolved, and preneoplastic human esophageal epithelium for the presence of human chorionic gonadotropin (HCG), human placental lactogen (HPL), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and nonspecific cross-reacting antigen (NCA) using the unlabeled antibody peroxidase-antiperoxidase technique. HCG immunoreactivity was identified in 10 of 33 squamous cell carcinomas (33%), in 1 of 6 adenocarcinomas (17%), and 1 of 6 preneoplastic esophageal lesions (17%); while 9 of 33 squamous cell carcinomas (33%) and 1 of 6 adenocarcinomas (17%) contained immunoreactive AFP. Immunoreactive HPL was detected in 6 of 33 squamous cell carcinomas (20%), but in none of the adenocarcinomas. Neither AFP nor HPL immunoreactivity was identified in the 6 hyperplastic lesions which were studied. When stained with an antiserum that was able to detect both CEA and NCA, 27 of 33 squamous cell tumors (82%) and 6 of 6 adenocarcinomas (100%) showed positive immunostaining reactions. Of these, 8 squamous cell carcinomas and 1 adenocarcinoma were subsequently shown to contain only NCA immunoreactivity, while 19 squamous cell carcinomas and 5 adenocarcinomas contained both NCA and CEA immunoreactivity. NCA immunoreactivity alone was identified in 3 of 6 preneoplastic lesions and NCA and CEA immunoreactivity in 1 of 6 preneoplastic lesions. None of the markers was detected in 8 specimens of normal esophageal epithelium which were studied as controls, nor in 6 specimens of uninvolved esophageal epithelium obtained from patients with esophageal cancer. Most tumors expressed 2 or 3 markers, and some tumors were identified which expressed up to 4 of the 5 markers investigated. Only 3 tumors failed to express any of the markers studied. No association was found between the degree of tumor differentiation and presence or absence of HCG immunoreactivity. However, HPL immunoreactivity was more common in poorly differentiated squamous cell carcinomas. In contrast, immunoreactive AFP was more common in well-differentiated squamous cell carcinomas than in other tumor types. Similarly, both CEA and NCA were more frequently expressed in well-differentiated squamous cell carcinomas, adenosquamous carcinomas, and adenocarcinomas than in less differentiated tumors. Our results suggest that HCG, HPL, AFP, CEA, and NCA are tumor-associated antigens in esophageal cancer. Therefore, they could be of value in screening tests for esophageal neoplasms and could be useful in subclassification of esophageal neoplasms.
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Maligant esophageal stenosis affects the qulity of the patients' life severely. Self-Expanding Metallic Stent (SEMS) can relieve the patient from dysphagia. In this article, we summarized the application and clinical complication of SEMS in maligant esophageal stenosis.
BACKGROUND: Adenocarcinoma and squamous cell carcinoma are the most frequent pathologic diagnoses with esophageal malignancy. Unusual pathologic variants are encountered in only 1% to 7% of patients, and therefore data evaluating the treatment and survival in this group of esophageal neoplasms are sparse. METHODS: To get more insight into the unusual pathologic variants, patients were selected from our computer-assisted database containing data from 426 consecutive patients treated with esophageal resection or enucleation at our institute during 1993 to 2000. RESULTS: Uncommon variants of esophageal neoplasms were encountered in 23 patients (5.3%). The following unusual histopathologic variants were seen: basaloid squamous cell carcinoma (n = 3), small-cell carcinoma (n = 1), leiomyoma (n = 5), gastrointestinal stromal tumor (n = 2), leiomyosarcoma (n = 1), adenosquamous carcinoma (n = 5), carcinosarcoma (n = 4), collision tumor (n = 1), and melanoma (n = 1). Presentation, histopathologic characteristics, treatment, and prognosis are described in reference to the existing literature. CONCLUSIONS: Survival data of the unusual pathologic variants seem to be comparable to those of the most frequently encountered neoplasms. Only in case of small-cell carcinoma does there seem to be a definite role for chemotherapy, especially in a multimodality treatment protocol.
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