Verrucous Squamous Carcinoma of the Esophagus: rare and difficult to diagnose

Fragestellung: A 54 year old male, heavy smoker, with a long history of alcohol abuse, presented presented with 4 month history of progressive dysphagia, but the physical examination was unremarkable. An upper endoscopy showed white papillary, spiked, wart-like appearing lesions involving the mid and lower esophagus from 28 cm to 41 cm from incisor teeth (Image 1) with no involvement of the gastroesophageal junction. The esophageal lumen was narrow, but without obstruction. Multiple biopsies were taken from this lesion, but the pathology report showed inflammation but no evidence of malignancy. Endoscopic examin…