2 | CASE PRESENTATION
A 51-year-old male heavy smoker was presented with a history of dysphagia. Electronic laryngoscopy showed a mass in right pyriform fossa and postcricoid region. Multiple biopsies were taken and examined pathologically showing well to moderately differentiated SCC. Then the patient received definitive concurrent chemoradiation in local hospital. Six months later, his symptoms reappeared and endoscopy showed a mass in right pyriform fossa. After he was admitted to our hospital, contrasted CT scanning demonstrated a heterogeneously enhancing 1.6 × 1.5 - cm laryngopharyngeal mass, mainly involving right pyriform fossa and right aryepiglottic folds (Figure 1). Pathology of gastroscopic biopsy showed moderately differentiated SCC of esophagus. The patient underwent total pharyngolaryngoesophagectomy. Pathology revealed sheets and cords of tumor cells with basophilic matrix in hypopharynx. The tumor cells showed scant cytoplasm and had typical small angulated and hyperchromatic nuclei (Figure 2). Immunohistochemistry revealed the tumor cells consist of epithelial or myoepithelial elements, i.e. CD117 positive in epithelial elements, P63, SMA and S100 positive in myoepithelial elements, supporting the diagnosis of ACC. And moderately differentiated esophageal SCC was also identified. The patient remained disease free on the date of last follow up.