Esophagus
Carcinoma
Superficial squamous cell carcinoma

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 24 January 2018, last major update March 2014

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Superficial squamous cell carcinoma[TIAB] esophagus

Cite this page: Weisenberg, E. Superficial squamous cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagussuperficialsquamous.html. Accessed August 20th, 2018.
Definition / general
  • Squamous cell carcinoma confined to the mucosa (T1a) or submucosa (T1b), regardless of lymph node status
Terminology
  • Sometimes referred to as early squamous cell carcinoma, especially in Japanese and Chinese literature
Epidemiology
  • In Japan, 10 - 20% of resection specimens for squamous cell carcinoma, much less common in North America and Europe
Sites, pathophysiology and etiology
Clinical features
  • Lesions mostly asymptomatic, found during endoscopy
  • Patients may also harbor squamous cell carcinoma of lung or upper aerodigestive tract
  • Lesions may be difficult to find endoscopically; negative Lugol iodine staining may enhance detection
Radiology images

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Two smooth round defects

Prognostic factors
  • Presence of lymph node metastasis is a poor prognostic factor
  • T1N0 disease is stage IA with 5 year survival ~ 70% (AJCC)
  • T1N1 disease is stage IIB with 5 year survival ~ 40% (AJCC)
Case reports
Treatment
Clinical images

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Polypoid lesion with a partially irregular surface

Esophageal neoplasm

Gross description
  • Japan Esophageal Society classification:
    • 0 - I: (protruding type) polypoid or plaque-like
    • 0 - IIa: slightly elevated
    • 0 - IIb: flat
    • 0 - IIc: slightly depressed
    • 0 - III: superficial and excavated
Gross images

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Small ulcer covered by blood clot

Plaque-like tumor is irregular, slightly elevated

Plaque with small polyp



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Multiple polypoid tumors

Microscopic (histologic) description
  • Invasive nests with irregular borders in lamina propria or submucosa
  • Often multicentric
  • Invasive focus often has larger, more squamous appearing cells than overlying surface component
  • Often adjacent dysplastic epithelium
  • By definition, no invasion of muscularis propria
Microscopic (histologic) images

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Tumor invades into middle of submucosa



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With leiomyomas

H&E

With leiomyoma

Differential diagnosis
  • Dysplasia involving ducts
  • Tangential sectioning of papillary or undulating dysplastic lesions
Additional references