Esophageal carcinosarcoma: A rare case report

Mahmoud Reza Kalantari; Mohadeseh Karimi; Ramin Mashoufi; Farzaneh Ramezani; Farzaneh Farshidi

doi:10.1016/j.ijscr.2025.111633

Esophageal carcinosarcoma: A rare case report

Int J Surg Case Rep. 2025 Aug:133:111633. doi: 10.1016/j.ijscr.2025.111633. Epub 2025 Jul 7.

Authors

Mahmoud Reza Kalantari¹, Mohadeseh Karimi², Ramin Mashoufi³, Farzaneh Ramezani⁴, Farzaneh Farshidi⁵

Affiliations

¹ Department of Pathology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran. Electronic address: kalantarim@mums.ac.ir.
² Department of Pathology, Faculty of Medicine, Hormozgan University of Medical Sciences, University of Hormozgan, Bandar Abbas, Iran. Electronic address: m.karimi@hums.ac.ir.
³ Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: raminemrama@gmail.com.
⁴ Dept. of Pathology, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran. Electronic address: Farzanermm@gmail.com.
⁵ Department of Pathology, Faculty of Medicine, Hormozgan University of Medical Sciences, University of Hormozgan, Bandar Abbas, Iran.

Abstract

Introduction: Esophageal carcinosarcoma (ECS) is a rare malignant tumor with a polypoid configuration. It is biphasic and composed of epithelial carcinomatous and mesenchymal sarcomatous components.

Case presentation: We present a 74-year-old Persian woman with a known case of hypertension and chronic renal insufficiency who presented with dysphagia one month ago. On presentation she was oriented, with normal ranged Vital signs. The vital signs were within normal ranges. Her physical examination revealed pale conjunctiva. Gastrointestinal endoscopy showed a 29*25 mm ulcerative polypoid lesion in the distal part of the esophagus which several biopsies were taken. Microscopic examination revealed biphasic mesenchymal and epithelial malignant tumors compatible with carcinosarcoma.

Discussion: Dysphagia is the most common symptom of ECS. Immunohistochemistry is the diagnostic gold standard for ECS. The markers for the carcinomatous elements are CEA, EMA, pancreatin, chromogranin A, CD56, and synaptophysin, and for the sarcomatous elements, desmin, p63, vimentin, and smooth muscle/sarcomeric actin.

Conclusion: ECS is a biphasic tumor and the most effective treatment option for ECS is surgical resection.

Keywords: Carcinosarcoma; Esophagus; Tumor.

Publication types

Case Reports