2 | CASE PRESENTATION
A 51-year-old male heavy smoker
was presented with a history of dysphagia. Electronic laryngoscopy
showed a mass in right pyriform fossa and postcricoid region. Multiple
biopsies were taken and examined pathologically showing well to
moderately differentiated SCC.
Then the patient received
definitive concurrent chemoradiation in local hospital. Six months
later, his symptoms reappeared and endoscopy showed a mass in right
pyriform fossa. After he was admitted to our hospital, contrasted CT
scanning demonstrated a heterogeneously enhancing 1.6 × 1.5 - cm
laryngopharyngeal mass, mainly involving right pyriform fossa and right
aryepiglottic folds (Figure 1). Pathology of gastroscopic biopsy showed
moderately differentiated SCC of esophagus. The patient underwent total
pharyngolaryngoesophagectomy. Pathology revealed
sheets and cords of tumor cells
with basophilic matrix in hypopharynx. The tumor cells showed scant
cytoplasm and had typical small angulated and hyperchromatic nuclei
(Figure 2). Immunohistochemistry revealed the tumor cells consist of
epithelial or myoepithelial elements, i.e. CD117 positive in epithelial
elements, P63, SMA and S100 positive in myoepithelial elements,
supporting the diagnosis of ACC. And
moderately differentiated
esophageal SCC was also identified. The patient remained disease free on
the date of last follow up.