A Difficult-to-Diagnose Case of Small Cell Carcinoma with Polypoid Features that Arose in the Cervical Esophagus

Go Watanabe, Atsushi Itami, Masato Kondo, Shinichi Miyamoto¹⁾, Akihiko Yoshizawa²⁾ and Yoshiharu Sakai

Department of Surgery, Department of Gastroenterology & Hepatology¹⁾ and Department of Pathology²⁾, Graduate School of Medicine Kyoto University

A 58-year-old woman with a sore throat since December 2005 and gradually developing dysphagia was no longer able to ingest solid food in March 2006. She was found to have a giant polyp 5 cm in length with polypoid features on a narrow stalk arising in the cervical esophagus covered by normal esophageal epithelium. CT and MRI showed no invasion of surrounding tissues and pathological examination indicated no evidence of malignancy. The mass judged to be a benign esophageal polyp, was resected endoscopically. Pathological evaluation yielded a definitive diagnosis of small cell carcinoma. Local recurrence in the esophagus was diagnosed 6 months after the initial resection. Irradiation alone at a dose of 30 Gy induced complete remission. She is presently living with no evidence of recurrence. Nearly all giant polyps arising in the cervical esophagus have been reported to be benign. The differential diagnosis of esophageal tumors should therefore include malignant tumors of uncommon histological type rarely associated with polypoid features.

Key words
small cell carcinoma, esophageal polyp, endoscopic resection

Reprint requests
Go Watanabe Department of Surgery, The Japan Baptist Hospital
47 Yamanomoto-cho, Sakyo-ku, Kyoto, 606-8273 JAPAN

Accepted
October 22, 2008

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