title: [A case of mixed adenoneuroendocrine carcinoma of the esophagogastric junction treated with neoadjuvant chemotherapy].
abstract: We present a case of a 63-year-old man who was admitted to another hospital because of abdominal distension and body weight loss. Gastric endoscopy revealed a type III tumor at the posterior wall of the upper gastric body. The tumor had invaded into the esophagogastric junction. On the basis of the pathology of the biopsy specimen, the tumor was diagnosed as neuroendocrine carcinoma of the esophagogastric junction. Computed tomography (CT) scans showed regional lymph node swelling. Cisplatin( CDDP) +irinotecan( CPT-11) therapy was selected and administered to the patient. After 2 courses, the patient received S-1+CDDP. He was considered to have stable disease. We performed partial resection of the lower esophagus, total gastrectomy, splenectomy, and cholecystectomy. On pathology, the tumor was immunohistochemically positive for chromogranin A, AE1/AE3, neural cell adhesion molecule (NCAM), neuron-specific enolase (NSE), and p53. The Ki-67 index was 80%. The tumor was diagnosed as a mixed adenoneuroendocrine carcinoma (MANEC) of the esophagogastric junction. The patient was treated with S-1 and CDDP. Neuroendocrine cell carcinoma of the esophagogastric junction is rare and usually has a very poor prognosis. We herein report a case of mixed adenoneuroendocrine carcinoma of the esophagogastric junction that was curatively resected and resulted in patient survival without recurrence.
authors.affiliation: Dept. of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kawasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Wajima
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kimura
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Muroya
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Yonaiyama
authors.forename: Kensuke
authors.initials: K
authors.lastname: Okano
authors.forename: Hayato
authors.initials: H
authors.lastname: Nagase
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hakamada
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D004943:Esophagogastric Junction / Q000473:pathology* / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin