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Cervical Esophageal Cancer

Determining the Type of Cervical Esophageal Cancer

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Ideally, your doctor and pathologist should specialize in head and neck cancers because some benign (non-cancerous) lesions can look like cancer on a small biopsy.

  • Squamous cell carcinoma: These are by far the most common cervical esophageal cancers.1 Krause CJ, Carey TE, Ott RW, Hurbis C, McClatchey KD, Regezi JA. Human squamous cell carcinoma. Establishment and characterization of new permanent cell lines. Arch Otolaryngol. Nov 1981;107(11):703-710. They arise from cells lining the upper part of the cervical esophagus.
    • Squamous cell cancers of the esophagus are typically given a grade by a pathologist after looking at the cells under a microscope. Grade means that the tumor falls on a scale from well differentiated (Grade I) to poorly differentiated (Grade IV). It is generally felt that the prognosis for a more well-differentiated cancer is more favorable.
  • Adenocarcinoma: This type of cancer is from the gland-type cells in the esophagus. Adenocarcinoma is very rare in the cervical esophagus. It is much more common in the lower third of the esophagus.

More rarely, other cancers can be found in the cervical esophagus as well. Some of them include:

  • Lymphoma: The throat is lined with lymphoid cells. This is why lymphoma might appear as a lump in the throat area.
  • Carcinoid: This is a very slow growing tumor that is very rarely found in the esophagus, particulary the cervical esophagus (the most common site for this type of tumor is the appendix).6 Modlin IM, Shapiro MD, Kidd M. An analysis of rare carcinoid tumors: clarifying these clinical conundrums. World J Surg. 2005 Jan;29(1):92-101. Carcinoid tumor is a neuroendocrine tumor, which means the tumor cells can actually secrete hormones into the blood stream. It is typically a benign tumor but can occasionally become cancerous. Some carcinoids (about 10%) can actually secrete hormones and lead to “carcinoid syndrome,” which is characterized by diarrhea, turning red, cramps that come and go, wheezing and other symptoms (sometimes made worse with having wine and cheese).7Vinik, A. I., Thompson, N., Eckhauser, F., & Moattari, A. R. (1989). Clinical features of carcinoid syndrome and the use of somatostatin analogue in its management. Acta Oncologica, 28(3), 389-402.

Other extremely rare cancers of the cervical esophagus include:

  • Sarcomas such as leiomyosarcoma, liposarcoma, rhabdomyosarcoma
  • Malignant fibrous histiocytoma
  • Peripheral Neuroectodermal Tumor (PNET)
  • Cancer spread from another site
References

1 Krause CJ, Carey TE, Ott RW, Hurbis C, McClatchey KD, Regezi JA. Human squamous cell carcinoma. Establishment and characterization of new permanent cell lines. Arch Otolaryngol. Nov 1981;107(11):703-710.

2 Moore C. Smoking and cancer of the mouth, pharynx, and larynx. JAMA: the journal of the American Medical Association. Jan 25 1965;191(4):283-286.

3 Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Cancer risk associated with alcohol and tobacco use: focus on upper aero-digestive tract and liver. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism. 2006;29(3):193-198.

4 Little MP. Cancer after exposure to radiation in the course of treatment for benign and malignant disease. The lancet oncology. Apr 2001;2(4):212-220.

5 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Esophageal and Esophagogastric Junction Cancers V.2.2016. ©National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 7, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

6 Modlin IM, Shapiro MD, Kidd M. An analysis of rare carcinoid tumors: clarifying these clinical conundrums. World J Surg. 2005 Jan;29(1):92-101.

7 Vinik, A. I., Thompson, N., Eckhauser, F., & Moattari, A. R. (1989). Clinical features of carcinoid syndrome and the use of somatostatin analogue in its management. Acta Oncologica, 28(3), 389-402.

8 Mariette C, Balon J-M, Piessen G, Fabre S, Van Seuningen I, Triboulet J-P. Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease. Cancer. 2003;97:1616-1623.

9 Key C and Meisner ALW. Chapter 3: Cancer of the Esophagus, Stomach, and Small Intestine. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.