Esophageal Carcinoma Cuniculatum

Abstract

Esophageal carcinoma cuniculatum is a rare histology and can be difficult to diagnose prior to resection. To date, there have been 28 cases of resected esophageal carcinoma cuniculatum reported. Herein we describe a case found in the stomach of a patient who previously underwent a Roux-en-Y gastric bypass surgery. We report the preoperative, intraoperative, and postprocedural care. We review gross and histologic pathology.

Figure 1

(A) Computed tomography scan of gastroesophageal mass with arrow noting lymph node. (B) Endoscopic view of proximal extent of gastric mass.

Figure 2

Postfixation gross photographs of the opened and complete Roux-en-Y esophagogastrectomy specimen with attached omentum, overall prior to sectioning (A), and on cross-section demonstrating the tunneling and verrucoid gross architecture of the tumor (B); transmural invasion is inked green.

Figure 3

Photomicrograph of hematoxylin and eosin–stained representative section of tumor, demonstrating tunneling architecture with pushing invasion and keratin formation on (A) low power (20x magnification), and (B) well-differentiated carcinoma with preserved squamous cell maturation, parakeratosis, dyskeratosis, and koilocyte-like cytology on 200x magnification.