Abstract
We report a rare case of multiple esophageal cancers with coexisting small–cell and squamous cell carcinoma. A 63–year–old woman seen for epigastralgia and admitted was found in endoscopy to have esophageal cancer–Type 2 in the upper thoracic esophagus (Ut) and Type 1 in the lower thoracic esophagus (Lt). Preoperative biopsy showed both to be squamous cell carcinoma. Preoperative computed tomography (CT) showed neither definite lymph node nor distant metastasis, and both lesions were diagnosed as T2 N0 M0 cStage II, necessitating radical esophagectomy and three–field lymph node dissection. Histopathologically, the Lt tumor was squamous cell carcinoma and the Ut tumor small–cell carcinoma. Immunohistochemical staining showed small–cell carcinoma cells positive for NSE and CD56 (NCAM). Metastatic small–cell carcinoma cells were found in lymph node No.105. CT 10 months postoperatively showed mediastinal and hilar lymph node, multiple liver, and spleen metastases. The woman died of the primary disease 12 months after surgery, underscoring the dismal prognosis faced by those with small–cell esophageal carcinoma.
