Undifferentiated Carcinoma of the Esophagus (non-small cell type) -A Case Report and Review of the Literature in Japan

Shin Saito, Yoshinori Hosoya, Wataru Arai, Masanobu Hyodo, Taku Yokoyama, Yuki Hirashima, Kentaro Kurashina, Hideo Nagai, Munetoshi Tukahara* and Ken Saito*

Department of Surgery and Department of Pathology*, Jichi Medical University

An 82-year-old male admitted for dysphagia was found in endoscopy to have a type 1 tumor involving the lumen in the lower esophagus, with biopsy suggesting undifferentiated carcinoma. The performance status was good without remote metastasis despite his advanced age, and surgery involved thoracotomy plus laparotomy. The middle and lower esophagus and the upper stomach were resected and an intrathoracic esophagogastroanastomosis (D2 dissection) done. Histologically, undifferentiated carcinoma of the esophagus (non small-cell) was suggested, as noted by the biopsy. According to the Regulations for Esophageal Cancer Treatment, the tumor was evaluated as pT2, pN1, M0, and stage II. Three months after surgery, multiple liver metastases and intraperitoneal lymph node metastasis were detected. Chemotherapy with low-dose FP achieved partial response of the metastatic foci, and the patient has been treated at the outpatient clinic for 9 months in postoperative follow-up. In Japan, 15 patients with non small-cell undifferentiated carcinoma of the esophagus have been reported. The prognosis is reported to be dismal, however, but chemotherapy administered to 6 of the 15 patients resulted in a response of 67% (4/6). In some patients, radiotherapy or surgical therapy alone markedly prolonged survival, and multidisciplinary treatment may improve the outcome.

Key words
undifferentiated carcinoma of the esophagus, non-small cell type

Reprint requests
Shin Saito Department of Surgery, Jichi Medical University
3311-1 Yakushiji, Minamikawachi-machi, Tochigi-ken, 329-0498 JAPAN

Accepted
June 30, 2004

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