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Z Gastroenterol 2020; 58(10): 971-974
DOI: 10.1055/a-1231-5820
Kasuistik

Verrucous carcinoma of the esophagus – a case report and literature review

Verruköses Ösophaguskarzinom – ein Fallbericht und Literaturübersicht
Thomas Frieling
1   Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany
,
Christian Kreysel
1   Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany
,
Michael Blank
1   Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany
,
Dorothee Müller
1   Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany
,
P. Euler
1   Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany
,
Ilka Melchior
1   Department of Internal Medicine and Gastroenterology, HELIOS Clinic Krefeld, Germany
,
Christoph Wullstein
2   Department of Visceral Surgery, HELIOS Clinic Krefeld
,
Bernhard Hemmerlein
3   Department of Pathology, HELIOS Clinic Krefeld, Germany
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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.

Zusammenfassung

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.

Key words

dysphagia - regurgitation - noncardiac chest pain - verrucous esophageal carcinoma

Schlüsselwörter

Dysphagie - Regurgitation - nichtkardialer Brustschmerz - verruköses Ösophaguskarzinom


Publication History

Received: 17 May 2020

Accepted: 25 July 2020

Article published online:
09 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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