Sarcomatoid Carcinoma of Mid Thoracic Esophagus – A Rare Variant in Esophageal Cancers

Aims: Sarcomatoid squamous cell carcinoma is the rarest variant of squamous cell carcinoma, which is more common at layrnx, hypopharynx, nasal cavity or oral cavity and only rarely encountered in the esophagus. Hence we present a case of sarcomatoid squamous cell carcinoma of mid esophagus which was difficult to diagnose and manage because of its rarity in our region.

Case Presentation: We report a case of sarcomatoid squamous cell carcinoma of mid esophagus which was initially diagnosed as gastrointestinal stromal tumor (GIST) of esophagus on endoscopic biopsy. After discussion with the multidisciplinary team of tumor board, McKeown esophagectomy was done. Final histopathology of the resected specimen turned out to be a sarcomatoid squamous cell carcinoma of the esophagus.

Discussion: Sarcomatoid carcinoma (SC), also known as polypoid squamous cell carcinoma or spindle cell carcinoma (SpCC), is a rare variant. It has dual histopathological appearances, i.e., either dysplastic squamous epithelium with an invasive spindle cell component, or dual epithelial and spindle cell morphology within the invasive tumor. Data published till date mostly have described this variant of squamous cell carcinoma according to histopathological perspectives. In this case report, we have described this rare variant, which will add to the current knowledge of clinical presentation and treatment of this rare entity.

Conclusion: Limited data regarding management and prognosis of this disease, increases the necessity of further investigation on the risk factors and prognostic indicators of this disease.