Is basaloid squamous carcinoma of the esophagus high-grade malignancy? A report of six cases

Basaloid squamous carcinoma of the esophagus (BSCE) is a rare malignant disease. We herein described six cases of BSCE treated by esophagectomy in our department, the clinicopathological features of which were analyzed. Only one of the six cases was diagnosed with BSCE prior to surgery. The depth of tumor invasion was T3 and T1b in 4 and 2 cases, respectively. Metastatic lymph nodes were detected in two cases of advanced carcinoma. All four cases of advanced carcinoma recurred and died of metastasis, and the period of disease-free survival and overall survival after surgery was 5-18 months and 24-42 months, respectively. On the other hand, as of 21 months and 52 months after surgery, two patients with superficial carcinoma have been free from recurrence. Immunohistochemistry revealed that the anti-phosphohistone H3 (PHH3) mitotic index (MI) was significantly higher and the p21 labeling index (LI) was significantly lower than those in conventional esophageal squamous cell carcinoma. Although BSCE immunohistochemically suggests high-grade malignancy, radical excision may contribute to a better outcome in the early stage.