Globally, an estimated 572 000 cases occurred in 2018 of malignant tumors of the esophagus but in
children and adolescents, this cancer is a rare disease. Through this case report, i tried to analyze the
clinical, paraclinical, therapeutic and prognostic profile of squamous cell carcinoma of the esophagus in
children. This 10 years old female school child is presented with a complaint of worsening of difficulty
of swallowing of 01 week duration. She had Symptoms complex of TB for the last 3 months. FNAC
from right axillary, bilateral inguinal LNs, discrete with pus oozing sinus tract about 2x2 cm Microscopy
shows caseous necrotic material= suggestive of TB. SAM (NE) + Severe Pneumonia + R/O Diss TB
(Lung, LN) + Tungiasis was considered and anti TB was started but the patient was deteriorating.
After one month course in the hospital the patient condition was deteriorating, the dysphagia become
worsened. CHEST CT SCAN of the child was taken and the Finding: there is multifocal coalescing tree
in bud opacity in posterior segment of the right upper lobe and superior segment of the lower lobe on the
same side. There is consolidation with bronchiectasis changes on the left lower lobe. Multiple enlarged
Para tracheal, sub carinal and Para esophageal nodes noted. There is circumferential wall thickening of
the mid and part of proximal esophagus with no fat plane from the enlarged adjacent nodes. Calcified
right axillary nodes visualized. the Impression was Bilateral pulmonary opacities with mediastinal
LAPs (likely 2ry to TB) + circumferential wall thickening of mid and part of proximal esophagus DDx:
Esophageal malignant mass with mediastinal nodal deposits and aspiration pneumonia- so needs clinical
correlation and endoscopic study. Esophageal biopsy was taken and section shows nests and single cells
of malignant squamous cells having high N/C ratio hyper chromatic nucleo and dense eosinophilic
cytoplasm along with keratin pearls along with monocular infiltration and atypical mitosis invading in
to desmoplastic stroma. Conclusion: Squamous cell carcinoma
The child was transferred to oncology ward for chemotherapy and radiotherapy after one week of ward
stay the patient passed away.
Malignant esophageal tumors in children and adolescents are extremely rare conditions. The ingestion of
caustic products and smoking are currently the most well-known risk factors for this disease, factors not
found in our patient. Dysphagia is the main clinical sign of squamous cell carcinoma of the esophagus.
Thus, in the event of dysphagia in children or adolescents, a mediastinal process should be considered,
and a paraclinical assessment should be carried out. Since squamous cell carcinoma of the esophagus
is a rare malignant tumor in children, the interest of this case report is to underline the importance of
evoking a malignant esophageal process in children who present a notion of dysphagia to solids then to
liquids, associated with an alteration of the general condition and anemia.
