A Case of Neuroendocrine Carcinoma of Esophagus, which Metastasized to the Liver at the Post-Operative Early Stage

Kanako Fujita, Makoto Kawaguchi¹⁾, Yutaka Miura²⁾, Nobuhiro Fujita and Ichirou Hokari

Department of Surgery and Department of Pathology, Niigata Rousai Hospital¹⁾
Department of Molecular Neurobiology, Graduate School of Medical Sciences, Nagoya City University²⁾

Small-cell neuroendocrine carcinomas are frequent in the bronchial tree but are very rare in the gastrointestinal tract. A 52-year-old man seen for dysphagia was found in endoscopic examination to have a polypoid lesion at the middle thoracic esophagus. Pathological examination of biopsy specimens showed neuroendocrine carcinoma. Since remote metastasis was not detected, we conducted esophagectomy through thoracolaparotomy. Histopathologically, the tumor was evaluated as pSMpN2IM0M0H0P0 Stage II based on Classification of Esophageal Carcinoma. Immunopathologically, positive staining was recognized for CD56, NSE, S-100 protein, chromograninA, and synaptophysin. Multiple liver metastasis and intraperitoneal lymph node recurrence were detected 1.5 months postoperatively and he died about 2 months thereafter. A detailed study of the tumor showed well-differentiated epithelium-like parts intermingled with poorly differentiated sarcoma-like parts. ATBF1 expression was found mainly in the nucleus of the epithelium-like parts and in the cytoplasm of the sarcoma-like parts, but was absent in the lymphatic spread.

Key words
neuroendocrine carcinoma, esophagus, ATBF1

Reprint requests
Kanako Fujita Department of Surgery, Niigata Rousai Hospital
1-7-12 Touuncho, Jouetsu, 942-8507 JAPAN

Accepted
November 30, 2005

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