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Case Reports
. 2014 Feb 15;7(3):1206-11.
eCollection 2014.

Collision tumor of the esophagus: report of a case with mixed squamous cell carcinoma and gastrointestinal stromal tumor

Ting Qian  1 , Feng Gao  2 , Mao-Zhen Chen  3 , Fan-Hua Meng  1 , Xiao-Jing Li  4 , Yong-Juan Liu  4 , Hua-Bin Yin  1
Affiliations
Case Reports

Collision tumor of the esophagus: report of a case with mixed squamous cell carcinoma and gastrointestinal stromal tumor

Ting Qian et al. Int J Clin Exp Pathol. .

Abstract

Esophageal cancer is mainly divided into squamous cell carcinoma and adenocarcinoma. Epidemiologically, the former contributes to 90% of worldwide esophageal cancer cases, while adenocarcinoma contributes to two-thirds of cases in developed countries. Although other rare types and collision with multiple histological types of tumors do occur in the esophagus, it is very rare for a gastrointestinal stromal tumor (GIST) to collide with an epithelial malignant tumor. To date, only three cases have been reported in the literature. The current study reported a 69-year-old male patient with squamous cell carcinoma and GIST in the middle esophagus. There was no merging of tissue components between these tumors. This study together with a literature review indicates that esophageal collision tumors have been increasingly reported in recent years. Histology and immunohistochemistry are needed to make a differential diagnosis. The exact oncogenic mechanism or the interaction of two independent neoplasms still remains to be determined, and further investigation, such as electron microscopy and genetic analysis, may help to elucidate the pathogenesis of the colliding tumors.

Keywords: Collision tumor; GIST; esophagus; squamous cell carcinoma.

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Figures

Figure 1
Figure 1
X-ray and CT images. A: Barium meal x-ray image showing a filling defect in the middle esophagus. B and C: CT images showing the thickened esophageal wall and the stenosis of the lumen in the middle esophagus.
Figure 2
Figure 2
Tumor histology. A: H&E staining of esophageal collision tumor. The GIST is on the right side, and the squamous cell carcinoma is on the left with a clear border between them (magnification, ×4). B: H&E staining showing the moderately differentiated squamous cell carcinoma with an infiltrative growth pattern and clear nuclear atypia (×40). C: H&E staining showing the GIST with spindle-shaped and epithelioid cells (×40).
Figure 3
Figure 3
Immunohistochemical staining. (A) Strong positive staining for p63 in the squamous cell carcinoma cells (magnification, ×40). (B) Strong positive staining for CD117 in the GIST (×40). (C and D) Ki67 staining in squamous cell carcinoma cells (C) and the GIST (D).
See this image and copyright information in PMC

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