Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five patients with polypoid esophageal sarcoma are reported. All had dysphagia similar to that occurring in epithelial carcinoma of the esophagus. The clinical diagnosis of sarcoma was suspected when barium swallow showed a large polypoid lesion. Biopsy was often inconclusive concerning the nature of the lesion except to identify it as a neoplastic process. In spite of their large size, the tumors remained superficial within the esophageal wall. Nodal or distant organ metastasis was absent in 4 of the 5 patients. The histology of these tumors suggests that so-called carcinosarcoma is an epithelial carcinoma of the esophagus with varying amounts of spindle cell features and should be considered separately from sarcoma arising from mesenchymal tissue. Unlike carcinoma, esophageal sarcoma has a favorable prognosis following radical resection, and recent advances in esophageal surgery have decreased the mortality and morbidity of esophagectomy.
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PMID:Polypoid sarcomas of the esophagus. A rare but potentially curable neoplasm. 118 May 95

Esophageal carcinosarcoma is a rare malignant tumor. The tumor is composed of both carcinomatous and sarcomatous elements. The multiple designations of names such as pseudosarcoma, pseudosarcomatous carcinoma, polypoid carcinoma etc. reflect the controversy on the nature of sarcomatous component of this lesion. We report a case of carcinosarcoma of esophagus occurred in a 67 year old male with progressive dysphagia. Esophageal polypoid tumor was found by endoscopy and was resected by esophagectomy. Carcinosarcoma was proved by demonstrating both carcinomatous and sarcomatous components in the tumor. Immunohistochemical studies revealed positive keratin stain in the sarcomatous area and positive vimentin stain in the sarcomatous area. The tumor was reported to have a better prognosis than that of the squamous cell carcinoma of esophagus in the literatures, especially in the survival rate.
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PMID:Carcinosarcoma of esophagus. Report of one case and review of the literature. 146 40

The clinical and pathologic characteristics of five patients with esophageal sarcomas are presented, including the only recorded esophageal Triton tumor (malignant schwannoma), the third recorded synovial sarcoma, two patients with carcinosarcoma, and one with leiomyosarcoma. All five patients were males who presented with dysphagia. Three tumors were in the cervical esophagus, and the remaining two were in the distal esophagus. On endoscopic examination, three of the tumors were noted to be polypoid, while the other two were sessile. Two patients presented with disseminated disease, and a third was locally unresectable. These three patients were treated with palliative intent. The remaining two patients underwent surgical excision and postoperative radiation therapy, and are alive and well 6 and 7 years following treatment. This experience suggests that combined modality therapy employing postoperative radiation may be effective in managing these rare lesions.
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PMID:Esophageal sarcomas. 165 95

Polypoid carcinoma of the esophagus is a rare variant of squamous carcinoma, which occurs typically in elderly patients who present with symptoms of dysphagia. This tumor has been given a variety of names, including spindle cell carcinoma, carcinosarcoma, and pseudosarcoma. These designations reflect the controversy surrounding the nature of the spindle cell component of this lesion. We have studied a case of polypoid carcinoma of the esophagus with immunoperoxidase staining for keratin which has been shown to be specific for epithelial cells. Positive staining for keratin was demonstrated in both the carcinomatous and spindle cell "sarcomatous" appearing components of the tumor, supporting the contention that this tumor is of entirely epithelial origin.
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PMID:Polypoid squamous carcinoma of the esophagus. A case report with immunostaining for keratin. 661 13

Carcinosarcomas are rare neoplasms that exhibit heterologous malignant epithelial and stromal components. We report two cases of salivary gland carcinosarcoma with immunohistochemical analysis and clinical follow-up that provide insights into the pathogenesis and behavior of these tumors. In one case, a 51-year-old black woman had a 15-year history of a hard, asymptomatic, infraauricular mass that recently had undergone rapid growth. The tumor showed adenocarcinoma and osteosarcoma. She died 9 months after diagnosis. In another case, a 78-year-old white woman had a large soft palate mass that had been present for several years and had recently caused dysphagia. The tumor showed adenocarcinoma and leiomyosarcoma. The patient is alive at 9 months follow-up. Although malignant epithelial and stromal components characterize carcinosarcomas, immunohistochemical studies suggest that both elements are derived from a common precursor cell, possibly of myoepithelial origin. These cases support this concept and perhaps suggest a spectrum of differentiation that this precursor cell may exhibit.
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PMID:Carcinosarcoma of salivary glands with unusual stromal components. Report of two cases and review of the literature. 762 Oct 32

Leiomyosarcomas of the esophagus are rare tumors of mesenchymal origin. Apropos of a case we present clinicopathological features, diagnostic procedures and management of this seldom tumor of the esophagus. Primary gastrointestinal sarcomas cause less than 0.5% of all esophageal malign tumors, and present in ca. 5% as esophageal leiomyosarcomas. The most frequent incidence ranges between the fourth and fifth decade of life. The tumors originate from the muscular layers of the esophageal wall and are localized predominantly in the middle and distal third of the esophagus. Dysphagia is the most important and leading symptom although it presents late in the course of the illness. Endosonography is at the time the most accurate method to establish the tumor size. Differentiation between leiomyoma and leiomyosarcoma is only possible by histopathological examination and may be difficult in certain cases. Histopathological grading of the tumors as low- and high-grade sarcomas in dependence of the number of mitosis affects predominantly the prognosis of these patients. Differential diagnosis includes spindle cell carcinoma and carcinosarcoma of the esophagus. The most effective therapy consists in the complete operative removal of the tumor, in these cases five years survival rates of 30 to 40% are achieved, strongly influenced by tumor differentiation and size.
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PMID:[Leiomyosarcoma of the esophagus. Clinical aspects, diagnosis and therapy based on an individual case]. 922 8

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.
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PMID:Pedunculated esophageal leiomyosarcoma: a case report. 1063 19

A pleomorphic (giant cell) carcinoma of the esophagus is reported in a 52-year-old man who had dysphagia and weakness. The 8-cm-high vegetating tumor consisted of solid sheets of poorly cohesive epithelioid cells broken into clusters by strands of stroma. Numerous giant cells showing phagocytic phenomenon were present. Immunochemical analyses demonstrated the epithelial origin of the neoplasm, although most of the tumor cells strongly expressed vimentin. Numerous tumor cells expressed synaptophysin. Neurosecretory granules were detected in some tumor cells on electron microscopic examination. The patient died 4 months after he became symptomatic. As far as we can ascertain, this is the first case report describing a pleomorphic carcinoma arising in the esophagus. This poorly differentiated carcinoma might be of neuroendocrine differentiation. In the esophagus, pleomorphic carcinoma must be distinguished from polypoid tumors such as carcinosarcoma and malignant melanoma.
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PMID:Pleomorphic giant cell carcinoma of the esophagus with coexpression of cytokeratin and vimentin and neuroendocrine differentiation. 1062 46

A case of carcinosarcoma arising from the intraepithelial spreading area of esophageal squamous cell carcinoma (SCC) is reported herein. A 64-year-old man was referred to our hospital for investigation of a sore throat and dysphagia. An endoscopic examination revealed a 2. 5-cm polypoid mass in the mid-esophagus. Esophagograms taken 1 month prior to consultation by our hospital and just before surgery revealed marked change within a period of less than 2 months from a 2-cm sessile elevated mass to a 4-cm polypoid mass with a lobular appearance. The resected specimen contained two lesions in the esophagus. The larger one measured 4.0 x 2.0 x 2.0 cm and had a pedunculated polypoid shape, while the smaller one, measuring 1 cm in diameter, was a plateau-type elevated lesion located 3 cm distal from the larger mass. Histologically, the distal smaller lesion was diagnosed as primary SCC associated with a high frequency of intraepithelial spread, while the larger polypoid mass was composed of spindle-shaped sarcomatous cells, arising from the intraepithelial spread of SCC. To our knowledge, this is the only reported case of esophageal carcinosarcoma arising from an area of intraepithelial spread of SCC that showed such surprisingly rapid growth.
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PMID:Rapid-growing carcinosarcoma of the esophagus arising from intraepithelial squamous cell carcinoma: report of a case. 1066 43

Carcinosarcoma of the esophagus is a rare malignant neoplasm, predominantly affecting men in their seventh decade of life. While presenting symptoms and anatomic location of squamous cell and carcinosarcoma of the esophagus are similar, the latter often presents as a large intraluminal polypoid mass on barium esophagram. The more favorable prognosis associated with carcinosarcoma versus other esophageal neoplasms has been attributed to early onset of symptoms, resulting in prompt diagnosis, and a lower propensity for tumor invasion. We report the case of an elderly woman presenting with dysphagia who was initially diagnosed with esophageal leyomyosarcoma. Final tumor pathology showed esophageal carcinosarcoma.
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PMID:Carcinosarcoma of the esophagus--pattern of recurrence. 1146 13


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