A Case of Early Recurrence after Additional Resection for Esophagogastric Junction Mixed Adenoneuroendocrine Carcinoma Following Non-Curative Resection by Endoscopic Submucosal Dissection

Abstract

A 72-year-old man underwent endoscopic submucosal dissection (ESD) for clinical diagnosis of esophagogastric junction neuroendocrine carcinoma (NEC), cT1b-SM1, N0, M0, cStage I. The pathological diagnosis was mixed adenoneuroendocrine carcinoma, pT1b-SM2, ly (+), v (+), pHM0, pVM0 that required additional resection. In the resected specimen, scattered tumor follicles mainly invading lymphatic vessels were found in the submucosa to subserosa of the stomach, and the pathological diagnosis was ESD-pT3, pN1, pM0, ESD-pStage III. VP-16+CDDP was administered as adjuvant chemotherapy, but liver metastasis recurred 4 months after the operation. Hepatic arterial infusion therapy was added, but was ineffective, and the patient died due to pneumonia. Esophageal NEC is likely to cause local progression and lymph node metastasis from an early stage. Our case indicates that careful judgment is required with regard to the indication of endoscopic resection for esophageal NEC.