CASE REPORT article
Front. Med.
Sec. Pathology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1558831
Primary Extraskeletal Osteosarcoma of the Esophagus with PPM1D-BCAS3 Fusion: A Case Report and Literature Review
Provisionally accepted- Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Background:Extraskeletal osteosarcoma (ESOS), a malignant soft tissue neoplasm characterized by the presence of osteoid or cartilage matrix, arises without bone involvement. ESOS within the esophagus is particularly rare. This study reported a case of esophageal ESOS with PPM1D-BCAS3 fusion, offering an analysis of its clinicopathological features and a comprehensive literature review aimed at advancing the diagnostic understanding of clinical pathologists.Case demonstration: A 76-year-old male presented with a two-month history of subxiphoid pain and dysphagia. Chest computed tomography CT revealed irregular mid-esophageal wall thickening and luminal stenosis, raising suspicion for mid-esophageal carcinoma. Painless endoscopic ultrasonography detected a hypoechoic intraluminal esophageal mass. Endoscopic submucosal dissection (ESD) and histopathological analysis confirmed primary ESOS of the mid-esophagus. No adjuvant therapy was administered postoperatively. However, the patient experienced a recurrence with multiple metastases nine months later.Conclusions: The diagnosis of esophageal ESOS, a condition of exceptional rarity, necessitates an integrative evaluation that encompasses clinical history, imaging modalities, and histopathological analysis, with a critical distinction from metastatic osteosarcoma and carcinosarcoma. This study presented the first case of esophageal ESOS with PPM1D-BCAS3 fusion treated via ESD, providing a significant point of reference for clinicians and pathologists. The management of ESOS demands vigilant monitoring and precise follow-up care.
Keywords: Extraskeletal osteosarcoma, esophageal, Pathological diagnosis, differential diagnosis, Gene Fusion
Received: 15 Jan 2025; Accepted: 26 May 2025.
Copyright: © 2025 Zeng, Li, Xu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jiafei Zeng, Affiliated Hospital of Zunyi Medical University, Zunyi, China
Jinjing Wang, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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