Inflammatory myofibroblastic tumor in the esophagus after treatment for superficial esophageal cancer

A 76-year-old man was referred to our hospital for treatment of a submucosal tumor in the esophagus. The patient had a history of superficial esophageal cancer treated by endoscopic resection and radiation. Positron emission tomography showed intense localized uptake of fluorodeoxyglucose on the esophageal mass. Transthoracic esophagectomy and reconstruction with a gastric tube were performed. Histopathological examination revealed that the tumor consisted of a proliferation of atypical spindle cells with infiltration of many inflammatory cells. The spindle cells were positive for vimentin, alpha smooth muscle actin, and anaplastic lymphoma kinase immunostaining. The Ki-67 labeling index was 10–20 %. The tumor was finally diagnosed as inflammatory myofibroblastic tumor. Late phase inflammation caused by radiation potentially had an effect on the occurrence of the tumor in this case. For tumors of the irradiated esophagus, especially, careful pretreatment examination and treatment strategies with consideration of the radiation damage are important to obtaining a favorable outcome.