A Case of Large Cell Endocrine Cell Carcinoma of the Esophagus

Abstract

Endocrine cell carcinoma of the esophagus carries a poor prognosis due to its aggressive malignancy. We report a case of large cell neuroendocrine cell carcinoma managed by multidisciplinary treatment. A 54-year-old man who was found in esophagography to have a protruded lesion of the esophagus was referred to our hospital. Biopsy specimens were histologically diagnosted as squamous cell carcinoma. Stage II squamous cell carcinoma T2N1M0 was diagnosed and thoracoscopic esophagectomy with three-field lymph node dissection and reconstruction by a gastric tube was performed after neoadjuvant chemotherapy. The final diagnosis was large cell endocrine cell carcinoma, categorized as T2N4M0, Stage IVa. Postoperatively, he underwent adjuvant chemotherapy but recurrence to the lymph nodes and the pleura occurred 3 months after the surgery. Despite chemotherapy with other anticancer drugs, his condition took turn for the worse and best supportive care was carried out. He died 8 months after the first treatment. Although the prognosis of endocrine cell carcinoma of the esophagus is poor, there are some reports describing that multidisciplinary treatment is important to gain long-term survival. No collective opinion, however, has been established as yet. In selecting multidisciplinary treatment for the disease, we have to keep the prognosis of the disease in mind, determine anticancer effect early, and convert to best supportive care if the treatment is ineffective.