Verrucous Carcinoma of the Esophagus.

A 77-year-old man with a chief complaint of dysphasia underwent esophagogastroduodenoscopy (EGD). We found a whitish warty mucosa and a cauliflower-like mass in the middle esophagus (Picture 1). The whitish fluffy lesion extended to the lower esophagus. The presence of irregularly shaped erosions and a circumferential area of stenosis were detected at the esophagogastric junction (Picture 2). On histopathologic examination of the surgically resected specimen, well-differentiated squamous carcinoma was found to have invaded the adventitia at the esophagogastric junction. The mucosal surface, except for the area at the esophagogastric junction, consisted of keratinizing squamous epithelium with minimal cellular atypia, which was limited to the mucosal layer (Picture 3, 4), and a diagnosis of verrucous carcinoma was made.

Picture 1.

Picture 2.

Picture 3.

Picture 4.

Verrucous carcinoma of the esophagus is extremely rare. For patients who show verrucous whitish protrusions in the esophagus on EGD, verrucous carcinoma should therefore be considered in the differential diagnosis. Multiple biopsies are recommended to confirm the diagnosis of verrucous carcinoma (1,2).