title: A Case of Endoscopically Complete Remission of Esophageal Neuroendocrine Tumors by Concurrent Chemoradiation Therapy.
abstract: Neuroendocrine tumors (NETs) of the esophagus are extremely rare, aggressive and have a poor prognosis. Combined therapy using chemotherapy, radiotherapy and/or surgery appear effective. Here, we present a patient with a complaint of dysphagia who was diagnosed with this rare tumor. Upper gastrointestinal endoscope of a 46-year-old female revealed a localized ulcerative lesion in the middle esophagus. Histologic exam of biopsy specimens indicated a neuroendocrine carcinoma. The tumor cells were arranged in microtubular structures, with small and round cells containing scanty cytoplasm. They were positive for synaptophysin and chromogranin A on immunohistochemical staining. A computed tomography scan showed an esophageal tumor with enlarged superior mediastinal lymph nodes and about 1.2 cm sized liver metastasis, similar to findings in PET-CT scanning. The patient was prescribed chemotherapy consisting of etoposide and cisplatin, which led to regression of disease on follow-up imaging study. She continues under clinical observation. We seek to increase awareness of this exceedingly rare but hazardous disease by sharing our unexpected finding.
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Myung Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hyun Yong
authors.initials: HY
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Jae Kyu
authors.initials: JK
authors.lastname: Seong
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hee Seok
authors.initials: HS
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Sun Hyung
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Duk Ki
authors.initials: DK
authors.lastname: Kim
mesh_terms: D002272:Carcinoembryonic Antigen / Q000032:analysis; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis* / Q000628:therapy; D059248:Chemoradiotherapy; D053379:Chromogranin A / Q000378:metabolism; D002945:Cisplatin / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D004945:Esophagoscopy; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D016708:Synaptophysin / Q000378:metabolism
chemical_list: D002272:Carcinoembryonic Antigen; D053379:Chromogranin A; D016708:Synaptophysin; D005047:Etoposide; D002945:Cisplatin
keywords: Endoscopy; Esophageal neoplasms; Neuroendocrine tumors