A Resected Case of Endocrine Cell Carcinoma of the Esophagus

Atsushi Sano, Junko Kikuchi, Yoshiteru Kobayashi, Hiroshi Taguchi and Munehiro Yokoyama*

Department of Surgery, Nishi-Tokyo Metropolitan Police Hospital
Department of Pathology, Tokyo Metropolitan Police Hospital*

Endocrine cell carcinoma (ECC) of the esophagus is a rare form of esophageal carcinoma having a dismal prognosis due to its aggressive malignancy. We report the case of a patient with ECC managed by resection and adjuvant chemotherapy. A 56-year-old man, suffering one month of postprandial epigastralgia, was found in esophagography and esophagoscopy to have an elevated 4 cm lesion of the middle and lower thoracic esophagus. Biopsy specimens were histologically diagnosted as undifferentiated carcinoma. We judged the man to be a candidate for curative surgery after preoperative examination found no distant organ metastasis, lymph node metastasis, direct adjacent tissue invasion. We conducted thoracic esophagectomy with three-field lymph node dissection and retrosternal reconstruction by gastric tube. Immunohistochemically, the tumor in the resected specimen stained positive for synaptophysin, chromogranin A, and NSE, yielding a definitive diagnosis of nonsmall-cell ECC, pT2pN2M0 pStage III. Postoperatively, he underwent 4 courses of adjuvant chemotherapy with CDDP and VP-16. He remains alive without evidence of recurrence in the 37 months as of this writing. Operative indications should be carefully determined due to the high risk of invasiveness. Multidisciplinary treatment such as chemotherapy could bring relatively long survival even after radical resection.

Key words
endocrine cell carcinoma of the esophagus, undifferentiated carcinoma of the esophagus, small-cell carcinoma of the esophagus

Reprint requests
Atsushi Sano Department of Surgery, Nishi-Tokyo Metropolitan Police Hospital
4-8-1 Nishimoto-cho, Kokubunji, 185-0023 JAPAN

Accepted
May 21, 2008

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