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Esophageal verrucous carcinoma arising from hyperkeratotic plaques associated with human papilloma virus type 51
Article first published online: 8 JUL 2010
© 2010 Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus
Diseases of the Esophagus
Volume 23, Issue 5, pages E17–E20, July 2010
How to Cite
Tonna, J., Palefsky, J. M., Rabban, J., Campos, G. M., Theodore, P. and Ladabaum, U. (2010), Esophageal verrucous carcinoma arising from hyperkeratotic plaques associated with human papilloma virus type 51. Diseases of the Esophagus, 23: E17–E20. doi: 10.1111/j.1442-2050.2010.01087.x
- Issue published online: 19 JUL 2010
- Article first published online: 8 JUL 2010
Esophageal verrucous carcinoma is a rare variant of esophageal squamous cell carcinoma. We report a case of esophageal verrucous carcinoma associated with human papilloma virus (HPV) type 51. The patient had long-standing dysphagia and odynophagia, and white esophageal plaques showing hyperkeratosis on biopsy. At repeat endoscopy, the esophagus was covered with verrucous white plaques and areas of nodular mucosa with white fronds, with a distal 10-cm smooth mass protruding into the lumen. Biopsies demonstrated an atypical squamoproliferative lesion but no frank malignancy. HPV type 51 DNA was detected in endoscopic biopsy specimens by polymerase chain reaction. Because the size of the lesion favored an underlying verrucous carcinoma, our patient underwent minimally invasive esophagectomy with gastric pull-up and cervical anastomosis. The pathologic diagnosis was a well-differentiated esophageal verrucous carcinoma. One year after esophagectomy, the patient feels well and is free of disease. Although HPV DNA was not detected in the cancer tissue obtained at surgery, our case suggests an association between HPV type 51 and esophageal verrucous carcinoma. The clinical evolution in this case highlights the importance of endoscopic surveillance in patients with exuberant esophageal hyperkeratosis, and of definitive surgical resection when malignancy is suspected even if frank malignancy is not demonstrated on superficial biopsies.