Neuroendocrine carcinoma of the esophagus with an adenocarcinoma component
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A 68-year-old male was referred with dysphagia. Endoscopic findings showed circular stenosis with a protruding mass in the lower esophagus. Biopsy showed adenocarcinoma and there was no evidence of distant metastases. A subtotal esophagectomy was performed. The resected specimen revealed a mixed neuroendocrine carcinoma with adenocarcinoma. The adenocarcinoma component was on the surface of the tumor and the neuroendocrine component invaded the deeper portion. Immunohistochemically, the neuroendocrine carcinoma component stained positive for cytokeratin 7 and cytokeratin 20, suggesting that the neuroendocrine carcinoma originated from the adenocarcinoma. The adenocarcinoma component stained positive for MUC2, which suggests that the adenocarcinoma component originated from Barrett’s epithelium. Taken together, the neuroendocrine carcinoma may have originated from Barrett’s epithelium. A metastasis to the liver was found 2 months after the surgical resection. Chemotherapy was administered, but there was no response. Most esophageal neuroendocrine carcinomas are accompanied by adenocarcinoma or squamous cell components, suggesting that these carcinomas originate from pluripotent cells in squamous or Barrett’s epithelium. Appropriate chemotherapy for these lesions should be considered based on the cell of origin.
KeywordsEsophageal neuroendocrine carcinoma Mixed adenoneuroendocrine carcinoma Barrett’s esophagus Origin of neuroendocrine carcinomas
Squamous cell carcinoma
The authors declare no conflicts of interests and no funds regarding the publication of this paper.
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Conflict of interest
Yuki Kaneko, Shin Saito, Kazuya Takahashi, Rihito Kanamaru, Shiro Matsumoto, Yoshinori Hosoya, Hirofumi Fujii, Joji Kitayama, Toshiro Niki, Alan Kawarai Lefor and Naohiro Sata declare that they have no conflict of interest.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Written informed consent was obtained from the patient for publication of this case report and accompanying images.
The need for ethical approval for this paper was waived by the committee of Jichi Medical University Hospital.
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