Infección por papilomavirus humano y cáncer esofágico: reporte de caso / Human papillomavirus infection and esophageal cancer: a case report

Introducción. Actualmente se reportan más de 216 tipos de virus de papiloma humano (VPH), pero sólo 100 tipos han sido totalmente secuenciados. Son capaces de infectar las células de la capa basal de cualquier epitelio. Existe constancia del carácter oncogénico de los VPH. Objetivo. Describir con fines científico-documental para los profesionales y docentes un caso con infección esofágica por VPH y cáncer del esófago. Caso Clínico. Mujer de 63 años, raza negra, soltera, ama de casa, procedencia rural, fumadora, ingestión frecuente de bebida alcohólica. Cuatro meses antes del diagnóstico la paciente empieza a presentar de manera progresiva disfagia a sólidos y pérdida de peso. El estudio endoscópico alto demostró la presencia de una lesión proliferativa ulcerada en tercio medio del esófago. La biopsia esofágica demostró un carcinoma epidermoide. La citología sugestiva de infección por papilomavirus. Discusión. La papilomatosis esofágica previa con otros factores de riesgo contribuyó a la aparición del carcinoma esofágico. El estudio histopatológico concluyó el diagnóstico de carcinoma de células escamosas causado probablemente por infección por VPH. Conclusiones. La presente asociación es poco frecuente; pero posible de diagnosticar teniendo en cuenta la sospecha, factores de riesgo y recursos diagnósticos actuales.

Introduction. Currently over 216 types of human papillomavirus (HPV) have been reported, but only 100 have been fully sequenced. They are able to infect cells of the basal layer of any epithelium. Evidence of HPV oncogenicity has been found. Objective. To describe a case of esophageal HPV infection associated to cancer of the esophagus. Case report. 63 years-old, African and rural origin, single, female housewife with the habit of smoking and frequent ingestion of alcohol. Four months before the diagnosis was established, the patient began to gradually develop dysphagia to solids and weight loss. Upper endoscopy shows a proliferative ulcerated lesion in the middle third of the esophagus. Biopsy is consistent with esophageal squamous cell carcinoma. Cytology is suggestive of papillomavirus infection. Discussion. Prior esophageal papillomatosis and other risk factors contributed to the occurrence of esophageal carcinoma. Histopathology was consistent with the diagnosis of squamous cell carcinoma probably caused by HPV infection. Conclusion. The association between papilloma virus and esophageal cancer is rare but can be diagnosed if it is suspected and other risk factors are present, as well as if there is access to modern diagnostic means.

Esophagectomy and cervical side-to-side stapled esophagogastric anastomosis / 中南大学学报(医学版)

ObjectiveTo determine the clinical effect and the prospect of cervical side-to-side stapled esophagogastric anastomosis. MethodsEighteen cases of upper and middle thoracic esophageal carcinoma were treated with esophagectomy and cervical side-to-side stapled esophagogastric anastomosis. The clinical data were collected and retrospectively analyzed. The average age of patients was 60.7 years and the ratio of male to female was 17∶1. The tumor included 4 upper part and 14 middle thoracic parts. The length of tumors was from 1 cm to 7 cm, with an average of 3.2 cm.ResultsThe post-operative TNM staging(AJCC) included 4 Stage Ⅱa,9 Stage Ⅱb,and 5 Stage Ⅲ. The operative incisions included 8 nontransthoracic cervical and abdominal double incisions, 9 right cervico-thoraco-abdominal triple incisions, and 1 left cervico-thoracic incision. One (5.56%) patient complicated with anastomotic leakage and was cured in 2 weeks by cervical drainage and absolute diet. All the 18 patients were followed up for 1 to 5 years,and no anastomotic stricture was found. Reflux esophagitis was found in 2 and the incidence rate was 11.11%.ConclusionCervical side-to-side esophagogastric anastomosis is a safe procedure with larger resection of margins and fewer complications. It is worth replicating.

A Case of Synchronous Double Primary Cancer with Esophageal Small Cell Carcinoma and Lung Squamous Cell Carcinoma / 대한소화기내시경학회지

Double primary cancer means that more than two cancers with different origin exist independently in an individual. The diagnosis of double primary cancer was determined by following criteria. Each of the tumors must present a definite picture of malignancy, each must be distance, and the probability of one being a metastasis of the other must be excluded. Primary small cell carcinoma in the esophagus is relatively rare, and rarer when it is combined with other malignant disease. A review of the Korean medical literature failed to reveal any previously described the case of syn-chronous double primary cancer of primary esophageal small cell carcinoma and squamous cell carcinoma of lung. Recently, we have experienced a case of double primary cancer, a 65-year-old man with primary esophageal small cell carcinoma and squamous cell carcinoma of lung, which were diagnosed by endoscopic biopsy and bronchoscopic biopsy.

A clinical study in undifferentiated small cell carcinoma of the esophagus / 中国癌症杂志

Background and purpose:Esophageal cancer(EC) is one of the most common cancers that account for cancer-related deaths and over 400,000 new cases has been diagnosed per year.The morbility of small cell carcinoma of the esophagus(SCEC) is very low.This paper was to study was the clinical characteristics,treatment and prognosis of undifferentiated small cell carcinoma of the esophagus(SCEC).Methods:From 1961 to 2003,743 patients with SCEC were treated in different hospitals.The number of small cell carcinoma of the esophagus seen accounted for 1.38% of esophageal cancer treated in those hospitals in the same period.the average age was 56.8(range,51 to 66).511 of patients were male and 232 female.2 of them had primary tumor in the cervical proportion of the esophagus,68 in the upper thoracic proportion,420 in the mid thoracic proportion,252 in the lower proportion and 1 in the whole esophagus.88 patients were treated by surgery alone,23 by radiotherapy alone,24 patients by chemotherapy alone and all other of patients were treated by combined modality.Results:The median survival was 12.4 months for all patients,with 10.8 months for surgery,6.2 months for radiotherapy,6.6 months for chemotherapy,14.7 months for surgery combined with radiotherapy,16.1 months for surgery combined with chemotherapy,12.3 months for chemoradiotherapy and 16.2 months for surgery combined with chemoradiotherapy,respectively.The survival rates at 1,2,3,4,and 5 years were 56.4%、27%、19.3%、11.1%、(9.7%) for the whole group,respectively.Conclusions:We recommend that combined modality should be used for SCEC.The combination of surgery and multi-drug chemotherapy may improve the treatment outcomes for the patients with early stage SCEC.