Pleomorphic giant cell carcinoma of the esophagus with coexpression of cytokeratin and vimentin and neuroendocrine differentiation

A pleomorphic (giant cell) carcinoma of the esophagus is reported in a 52-y ear-old man who had dysphagia and weakness. The 8-cm-high vegetating tumor consisted of solid sheets of poorly cohesive epithelioid cells broken into clusters by strands of stroma. Numerous giant cells showing phagocytic phen omenon were present. Immunochemical analyses demonstrated the epithelial or igin of the neoplasm, although most of the tumor cells strongly expressed v imentin. Numerous tumor cells expressed synaptophysin. Neurosecretory granu les were detected in some tumor cells on electron microscopic examination. The patient died 4 months after he became symptomatic. As far as we can asc ertain, this is the first case report describing a pleomorphic carcinoma ar ising in the esophagus. This poorly differentiated carcinoma might be of ne uroendocrine differentiation. In the esophagus, pleomorphic carcinoma must be distinguished from polypoid tumors such as carcinosarcoma and malignant melanoma.