Last reviewed 01/2018

Oesopahgeal tumours are classified into

  • epithelial tumours - include papilloma, intraepithelial neoplasia, carcinoma and carcinoid tumours
  • non epithelial tumours - leiomyoma, lipoma, gastrointestinal (1)

Squamous cell carcinoma (SCC) is the predominant histological subtype and is mainly found in the upper two thirds of the oesophagus.

  • is thought to develop from squamous dysplasia/intraepithelial neoplasia.
    • dysplastic squamous epithelium is characterised by cytologic and architectural abnormalities
    • these lesions are usually confined to the epithelium
  • invasion of these neoplastic squamous cells into lamina propria and deeper layers results in invasive oesophageal SCC (2,3)

Adenocarcinoma usually arises in a region of specialised columnar epithelium (SCE) metaplasia in the lower third of the oesophagus.

  • there is glandular differentiation that arises in the setting of Barrett’s oesophagus (BE)
  • rarely may arise from heterotrophic gastric tissue or the submucosal glands with a similar morphology to Barrett’s associated tumours (2,3)

Dissemination of the tumour may occur in three ways:

  • direct spread - occurs both laterally, through the component layers of the oesophageal wall, and longitudinally within the oesophageal wall
  • via lymphatics - occurs commonly
  • haematogenous spread - spread may involve a variety of different organs including the liver, lungs, brain and bones (3)