A Case of Neuroendocrine Carcinoma of the Esophagogastric Junction with Mediastinal Lymph Node Metastasis

Abstract

A 72-year-old man was found to have thickened wall of the gastric cardia and lymphadenopathy by computed tomography (CT) taken for the purpose of detailed examination of epigastric discomfort. Upper gastrointestinal endoscopy showed a subcircumferential type 3 tumor at the esophagogastric junction, and a biopsy examination revealed adenocarcinoma. No distant metastasis was found. We performed robot assisted esophagectomy with two field lymph node dissection, and gastric tube reconstruction via an anterior mediastinal approach. As a result of histopathological diagnosis, synaptophysin, chromogranin A, and CD 56 were positive, respectively. The diagnosis was established as neuroendocrine carcinoma (NEC). Of the dissected lymph nodes, metastases were observed in No. 1, No. 2, No. 9, No. 11p, No. 107 and No. 110. Postoperatively, pneumonia, right recurrent nerve palsy, and wound infection occurred, and the patient was discharged 38 days after the surgery. He has remained free of the disease at 2 months postoperatively. NEC of the esophagogastric junction is considered rare, and here we report our case and a review of the literature.