Coexistence of esophageal superficial carcinoma and multiple leiomyomas: A case report

Figure 1 Barium swallow esophagograms. Lack of any marked change in two smooth round defects over the course of a year. A: On admission; B: One year later.

Figure 2 A: Endoscopic examination demonstrates a polypoid lesion with a partially irregular surface; B: Chromoendoscopy with Lugol’s iodine solution demonstrates a polypoid lesion located within the non-staining area and normal mucosa covering part of the surface.

Figure 3 Resected specimen. Multiple polypoid tumors of various sizes are covered with normal mucosa (circles). A polypoid lesion in the lower third of the esophagus exhibits an irregular surface. The broken line indicates the area of SCC.

Figure 4 Photomicrograph of cross-sections (squares) of the resected specimen. Leiomyoma tissue is located in all sections (arrows). S-1: CIS overlies the leiomyoma. The region of CIS extends to the oral side of the leiomyoma (bar). S-2: SCC invades the submucosal layer in a very narrow region. S-3: A section without abnormal macroscopic findings. Multiple small leiomyomas are observed only by microscopic examination.

Figure 5 High-power view of the regions indicated by small letters in Figure 4. A: Intraepithelial SCC; B: The SMT has low cellularity, appears strongly eosinophilic on hematoxylin-eosin staining, and is composed of interlaced smooth-muscle cells with hypovascularity and no mitosis; C: The SCC nest has invaded beyond the muscularis mucosae (MM); D: Two tiny leiomyomas, both originating from the muscular layer.