Esophagus
Carcinoma
Adenosquamous carcinoma
Author: Elliot Weisenberg, M.D.
Last author update: 1 September 2013
Last staff update: 16 December 2024 (update in progress)
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Adenosquamous carcinoma esophagus
Table of Contents
Definition / general | Etiology | Clinical features | Diagnosis | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosisCite this page: Weisenberg E. Adenosquamous carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophagusadenosquamous.html. Accessed December 22nd, 2024.
Definition / general
- Carcinoma that contains mixed elements of adenocarcinoma and squamous cell carcinoma, which remain clearly distinguishable within the tumor (WHO)
- Most authorities reserve term for tumors with substantial elements of each component as minor divergent differentiation is not uncommon
Etiology
- Believed to arise from totipotent basal stem cells that undergo heterologous differentiation (Gastroenterology 2002;122:784)
Clinical features
- Aggressive, behavior likely similar to squamous cell carcinoma (Oncology 2004;66:218)
- May present with smaller tumor size and lower stage than other carcinomas
- May be associated with Barrett esophagus (see case reports)
Diagnosis
- Endoscopic biopsy
Case reports
- 65 year old man with stage IV disease and survival of 6 years (Gan To Kagaku Ryoho 2006;33:231)
- 69 year old man with poorly differentiated tumor producing alpha fetoprotein (Anticancer Res 2003;23:3837)
- 72 year old man with Barrett esophagus (Jpn J Thorac Cardiovasc Surg 2002;50:537)
- With prominent spindle cells (Arch Pathol Lab Med 1993;117:544)
- At gastroesophageal junction (G Chir 2012;33:123)
Treatment
- Resection if possible
- Usually multimodality treatment
Microscopic (histologic) description
- Admixed squamous cell carcinoma and adenocarcinoma
Microscopic (histologic) images
AFIP images
Mucosa and submucosa
Positive stains
- Rarely necessary
- CD44 (in squamous areas), Alcian blue pH 2.5 in glandular component
Differential diagnosis
- Collision tumor: rare
- Minor component of squamous differentiation in adenocarcinoma or adenocarcinoma in squamous cell carcinoma
- Mucoepidermoid carcinoma: intimate mixture of squamous carcinoma, well formed glands producing mucin and intermediate cells
