Sarcomatoid carcinoma of the esophagus: a clinicopathological and immunohistochemical analysis

OBJECTIVE:To explore the clinicopathological and immunohistochemical features as well as the histogenesis of esophageal sarcomatoid carcinoma(SC).METHODS: Four cases of the esophageal SC were studied by histopathological observation and immunohistochemical staining.RESULTS: Three patients were male and 1 was female ranging in age from 44 to 69 years old (mean, 58.7 yr ). The major symptoms of the patients were progressive dysphagia and pain behind the sternum. Grossly, the tumors in 3 cases showed polypoid or fungiform in shape and protruded into the lumen of the esophagus with a short narrow pedicle, remaining 1 showed a giant ulcer. Microscopically, both carcinomatous and sarcomatous components were seen and transited each other. The sarcomatous elements formed the major part of the tumors. Immunohistochemically, the carcinomatous elements were positive for CK and EMA. The sarcomatous elements were positive for vimentin in 3 cases and for S-100 protein in the partial tumor cells in 2 cases, simultaneously positive for CK or EMA in 1 case.CONCLUSIONS: The esophageal SC is a rare malignant tumor that differs from the other type of esophageal carcinomas. The double phenotypes of the tumor may result from the cancer cell transforming to multi-direction.