Oesophageal Tumours - Squamous Cell Carcinoma

Malignant oesophageal tumours = 5% of cancers.
Most common = squamous cell carcinomas & adenocarcinomas
SCC = 90% of oesophageal carcinomas
Higher incidence in China & Japan
Western world, however, AdCa = SCC

Both present with:
Dysphagia
Weight Loss
Anaemia

Squamous Cell Carcinoma

Commonly presents in 50s & males

Risk Factors
Environment:
Diet
Nitrates (smoked/pickled foods)
Smoking
Alcohol
Nutritional deficiencies

Host:
Long-standing oesophagitis
Achalasia
Plummer-Vinson Syndrome

Pathology
Ill-defined genetic associations
Epithelial dysplasia leads to carcinoma in-situ (intraepithelial neoplasia) leads to invasive carcinoma

Ix
80% in lower 2/3 of oesophagus
Endoscopy
protruding (60%)
flat (15%)
excavating (25%)

Microscopy
Early/advanced (invasion of submucosa) lesions
Poorly differentiated/Well differentiated (Squamous cells with keratinization and intercellular bridges)

Staging = TNM classification

Cx

Metastases occur early to:

LNs

Mediastinum

Liver

Bone