Abstract
A 62-year-old man presented to our hospital because of dysphagia in July 2012 and was diagnosed with neuroendocrine carcinoma of the middle thoracic esophagus (cT3N1M0 cStage III) by close exploration. A total of four courses of chemotherapy with cisplatin /irinotecan yielded a complete cure for the lymph node lesion after the completion of the therapy. Esophagogastroduodenoscopy showed cicartrization of the main lesion with only surrounding non-staining band area. A biopsy revealed only components of squamous cell carcinoma and neuroendocrine carcinoma components had completely disappeared. We diagnosed the case as combined type of esophageal neuroendocrine carcinoma where squamous cell carcinoma components were left. We performed thoracoscopic subtotal esophagectomy in the prone position + three-field lymph node dissection in April 2013. Histopathology also did not show remnant neuroendocrine carcinoma but squamous cell carcinoma in the primary lesion. However, two of the dissected lymph nodes involved metastasis of neuroendocrine carcinoma. The patient developed brain metastasis of neuroendocrine carcinoma four months after the operation, and, despite intensive therapy, he passed away one year four months after the diagnosis.
