EXTENSIVE SPREADING CARCINOMA OF THE ESOPHAGUS WITH INVASION RESTRICTED TO THE SUBMUCOSA

Objectives: The aim of this study was to examine the clinicopathologic al features of extensive spreading type of squamous cell carcinoma (SC C) of the esophagus with invasion restricted to the submucosa. Methods : Thirty-eight submucosal SCC were studied histopathologically, and fi ve of these 38 submucosal SCC, which demonstrated an extensive spreadi ng-type SCC in which the size of the SCC was over 5 cm in longitudinal length while extending entirely across the esophageal lumen in a circ umferential spread, are described in detail. Results: The extent of SC C depended mainly on the extent of intraepithelial carcinoma (TEC) and ranged from 50 to 135 mm in longitudinal length. IEC existed continuo usly in four cases, and multiple IEC existed separately in one case. A n epithelium showing dysplasia was present in all cases, and the invol vement of the glands and ducts by IEC was present in two cases. There was only one invasive part of SCC observed in one case, and three to 1 0 invasive parts of SCC were observed in the other four cases; various features of invasion, including an invasive SCC from the esophageal g lands and ducts, were also present. Conclusions: The extensive spreadi ng-type SCC of the esophagus, which was considered to result from the widespread or multiple carcinomatous changes of the esophageal epithel ium, was found to not be as rare as generally thought. The multiple an d various features of the invasive parts of SCC suggested the simultan eous development of a downward invasion of SCC at different areas in e xtensive IEC.