Pseudosarcoma of the oesophagus

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Abstract
Pseudosarcoma of the oesophagus previously has been well documented in only six patients. The present case history illustrates the characteristics originally described by Stout of a polypoid lesion composed of sarcoma-like cells adjacent to squamous cell carcinoma. Earlier reports have postulated that the sarcomatous cells represent an unusual stromal proliferation in response to the adjacent squamous cell carcinoma. Another theory has been that the two cellular elements represent two separate lesions occurring coincidentally. Routine microscopic examination of the present lesion revealed it to be composed principally of pleomorphic spindle-shaped cells with areas of larger, more rounded cells resembling squamous carcinoma. However, electron microscopic examination of this tumour revealed that the sarcomatous cells contained tonofibrils and particularly desmosome-associated tonofibrils. These findings, we believe, definitely establish that the sarcoma-like cells originate from squamous epithelium. It is postulated that cells of both the sarcomatous and carcinomatous elements may be derived from the basal elements of the epithelium and this may account for the relatively benign clinical behaviour of this tumour.