A case of primary esophageal small cell carcinoma of the oat cell type was presented and a review of 93 cases of such tumors from the literature was made.
A 56-year-old woman with a four-week history of chest pain was found to have an ulcreative lesion in the lower portion of the esophagus. Biopsy specimens revealed an undifferentiated tumor composed of small cell carcinoma, closely resembling that of the bronchus. No evidence of pulmonary lesion was presented. After radiation therapy, radical esophagectomy was performed in December 1984, and pathological stage of mp, n4 (+), P10, M0, and Stage 4 by Japanese Society for Esophageal Disease criteria was made. Histological evaluation of radiation was moderately effective and only scant tumor nests were detected on the resected esophagus. The tumor cells of the biopsy specimen and lymph node deposits failed to show cytoplasmic argylophilia. But ultrastructural examination displayed a few cells containing membrane-bound neurosecretory granules. Indirect immunoperoxidase stain for ACTH and calcitonin were negative.
Between 1952 and 1984, 93 patients with small cell carcinoma of the esophagus were reported in the literature. They ranged in age from 29 to 88 years, averaging 64. The ratio of men to women was 1:0.68. All but five of these lesions were located in the middle or lower portion of the esophagus. Argylophilia was found in 34 of the 60 cases (56.7%), neurosecretory granules in 39 of 56 cases (69.6%), and the negative results could be explained by the paucity of these granules.
Although the dismal prognosis was disappointing, recent reports on chemotherapy have shown encouraging results, and we considered that radiation therapy and chemotherapy should be indicated for both adjuvant therapy in surgical operation and palliation of symptoms without surgical intervention.