Verrucous Squamous Cell Cancer of the Esophagus: A Case Report
Verrucous Cancer of the esophagus is basically a type of squamous cell carcinoma and is associated with a chronic inflammatory process in the lower esophagus usually secondary to gastro-esophageal reflux disease (GERD). Mostly it is a local disease process but sometimes it can invade distant structures also. We report a case is a 62-year-old female patient who presented with marked weight loss, anorexia, and difficulty to take solid food. On Upper GI endoscopy there was a warty appearing irregular mass at the mid to distal esophagus. Superficial multiple biopsies were taken but turned negative for malignancy and re-endoscopy after a few days with deep multiple biopsies revealed the diagnosis of verrucous carcinoma on histopathology. The patient was having multiple co-morbid conditions like hypertension, diabetes mellitus, and early nephropathy along with infiltration of malignancy in surrounding structures on CT scan chest. Therefore a decision was taken to place an esophageal stent by upper GI endoscopy followed by chemotherapy and radiotherapy by the oncology department. Patient symptoms were much relieved after 4 months of chemotherapy and radiotherapy and the patient is still on regular follow-up in medical OPD. Chronic inflammation due to gastritis and esophagitis is the main risk factor for verrucous carcinoma of the esophagus. Although surgery is the treatment of the choice for the local and early disease but as in our case disease was already spread palliative stenting followed by chemo-radiation is the best possible option that can be offered.
2. Kavin H, Yaremko L, Valaitis J, Chowdhury L: Chronic esophagitis evolving to verrucous squamous cell carcinoma: possible role of exogenous chemical carcinogens. Gastroenterology 1996. 110: 904-14.
3. Garcia FM, Lesquereux LM, Fernandez B, Parada P, Noia JL, Faya MS et al. Verrucous carcinoma of the esophagus: a complex diagnosis. Endoscopy 2010; 42 (2): 137-8
4. Minielly JA, Harrison EG, Fontana RS, Payne WS. Verrucous squamous cell carcinoma of the esophagus. Cancer. 1967;20(12):2078-87
5. Sweetser S, Jacobs NL, Wong Kee Song LM: Endoscopic diagnosis and treatment of esophageal verrucous squamous cell cancer. Dis Esophagus 2014; 27: 452-56.
6. Tonna J, Palefsky JM, Rabban J, Campos GM, Theodore P, Ladabaum U. Esophageal verrucous carcinoma arising from hyperkeratotic plaques associated with human papilloma virus type 51. Dis Esophagus.2010;23(5):177-84
7. Behrens A, Stolte M, Pech O, May A, Ell C: Verrucous oesophageal carcinoma: single case report and case series including 15 patients – issues for consideration of therapeutic strategies. Viszeralmedizin 2014; 30: 346-52. DOI: 10.1186/1756-0500-7-264
8. Brandalise A, Lorenzetti C, Aranha NC, Brandalise NA: Verrucous carcinoma of the esophagus involving the entire esophagus. Arq Bras Cir Dig 2015; 4: 293-8. DOI: /10.1590/S0102-6720201500030019
9. Devlin S, Falck V, Urbanski SJ, Mitchell P, Romagnuolo J. Verrucous carcinoma of the esophagus eluding multiple sets of endoscopic biopsies and endoscopic ultrasound: a case report and review of the literature. Can J Gastroenterol 2004; 18: 459-62
10. Odes HS, Maor E, Barki Y, Charuzi I, Krawiec J. Varicoid carcinoma of the esophagus: report of a patient with adenocarcinoma and review of literature. Am J Gastroenterol 1980; 73:141-45.
11. Osborn NK, Keate RF, Trastek VF, Nguyen CC: Verrucous carcinoma of the esophagus: clinicopathophysiologic features and treatment of a rare entity. Dig Dis Sci 2003; 48: 465-74.
12. Ahmed K, Timmerman G, Meyer R, Miller T, Mazurczak M, Tams K, Atiq M: Verrucous carcinoma of the esophagus: a potential diagnostic dilemma. Case Rep Gastroenterol 2013; 28: 498–502. DOI:/10.1590/S0102-6720201500030019
Copyright (c) 2022 Sumera Mushtaq, Ghulam Murtaza Gondal, Kiran Fatima, Tassawar Hussain
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
All research articles published in the Journal of Rawalpindi Medical College (JRMC) are fully open access: immediately freely available to read, download, and share. Copyrights of all articles published in JRMC are retained by the authors. First publication rights are granted to JRMC. The journal/publisher is not responsible for subsequent uses of the work.
All articles are published under the Creative Commons Attribution (CC BY-SA 4.0) license.