title: Small Cell Type of Esophageal Neuroendocrine Carcinoma Resembling a Submucosal Tumor.
abstract: We report a rare case of primary small cell type esophageal neuroendocrine carcinoma with a unusual endoscopic form similar to a submucosal tumor with the results of the histological and immunohistochemical analyses. A 57-year-old woman with dysphagia was referred to our hospital for further examination and treatment, and was diagnosed as type 1s esophageal carcinoma in the middle thoracic esophagus. Endoscopy revealed a protruding esophageal carcinoma resembling a submucosal tumor with an irregular and nodular surface covered by non-neoplastic epithelium stained with iodine. Analysis of the esophageal biopsy specimen revealed poorly differentiated squamous cell carcinoma. Based on a diagnosis of type 1s carcinoma in the middle thoracic esophagus that was 5 cm in size longitudinally, a radical esophagectomy with three-field lymph node dissection was performed. The pathological examination with histological and immunohistochemical analysis of the resected specimen revealed a small cell type neuroendocrine carcinoma overlaid by a non-neoplastic epithelium, extending into the adventitia without lymph node metastasis (T3, N0, M0, Stage II). However, multiple metastases in the brain and lung developed 3 months postoperatively, and the patient died of the cancer 7 months after the operation. This was a rare case of a highly malignant primary small cell type esophageal neuroendocrine carcinoma showing extremely rare form.
authors.affiliation: Department of Surgery, Tokai University School of Medicine, Tokyo Hospital, 1-2-5 Yoyogi, Shibuya-ku 151-0053, Japan. o-chino@is.icc.u-tokai.ac.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Chino
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
authors.forename: Soji
authors.initials: S
authors.lastname: Ozawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Shimada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kise
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hara
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Akihito
authors.initials: A
authors.lastname: Kazuno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kajiwara
mesh_terms: D001932:Brain Neoplasms / Q000556:secondary; D018278:Carcinoma, Neuroendocrine / Q000473:pathology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging