Skip to main content
SpringerLink
Log in

Small cell carcinoma with concomitant adenocarcinoma arising in a Barrett’s oesophagus: report of a case with a favourable behaviour

  • Case Report
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

Most Barrett’s oesophagus-associated cancers are adenocarcinomas which occur in a pure form. They are rarely combined with another type of malignancy, such as endocrine tumours. Within the endocrine spectrum, small cell carcinomas (SmCC) usually have a highly aggressive behaviour with a poor prognosis. We report a case of composite SmCC and adenocarcinoma in the setting of a Barrett’s oesophagus, in a 54-year-old man. This tumour was identified on a surgical specimen after neoadjuvant treatment with radiotherapy and 5-FU-Cis-platin based chemotherapy. The SmCC component was positive for chromogranin A, synaptophysin, neural cell adhesion molecule and neuron-specific enolase and negative for high molecular weight cytokeratin. The adenocarcinoma component showed a converse phenotype. In our case, the origin of the SmCC component could be explained by the numerous chromogranin A-positive cells observed in the Barrett’s oesophagus or by the potential progenitor cells that may be located in the submucosal oesophageal gland ducts and the Barrett’s metaplasia. Our report is thus indicative of the high and totipotential risk of Barrett’s oesophagus. Moreover, it is particular because of its favourable behaviour, with a 6-year disease-free survival, after neoadjuvant chemoradiation, surgery and postoperative chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Aaltonen LA, Hamilton SR (2007) (ed) World Health Organization classification of tumours. Pathology and genetics of tumours of the digestive system. Lyon 2000 ed. IARC

  2. Brenner B, Tang LH, Klimstra DS, Kelsen DP (2004) Small-cell carcinomas of the gastrointestinal tract: a review. J Clin Oncol 22:2730–2739

    Article  PubMed  Google Scholar 

  3. Buchan AM, Grant S, Freeman HJ (1985) Regulatory peptides in Barrett’s oesophagus. J Pathol 146:227–234

    Article  PubMed  CAS  Google Scholar 

  4. Caldwell CB, Bains MS, Burt M (1991) Unusual malignant neoplasms of the esophagus. Oat cell carcinoma, melanoma, and sarcoma. J Thorac Cardiovasc Surg 101:100–107

    CAS  Google Scholar 

  5. Coad RA, Woodman AC, Warner PJ, Barr H, Wright NA, Shepherd NA (2005) On the histogenesis of Barrett’s oesophagus and its associated squamous islands: a three-dimensional study of their morphological relationship with native oesophageal gland ducts. J Pathol 206:388–394

    Article  PubMed  Google Scholar 

  6. Hama Y, Uematsu M, Ichikura T, Tamura E, Aida S, Kohno M, Kusano S (1999) A case of primary small cell carcinoma of the cervical esophagus with long-term survival following concurrent chemoradiotherapy: case report and review of the literature. Tumori 85:284–287

    PubMed  CAS  Google Scholar 

  7. Jani AB, Connell PP, Vesich VJ, O'Brien KM, Chen LM (2000) Analysis of the role of adjuvant chemotherapy for invasive carcinoma of the esophagus. Am J Clin Oncol 23:554–558

    Article  PubMed  CAS  Google Scholar 

  8. Kanamoto A, Nakanishi Y, Ochiai A, Shimoda T, Yamaguchi H, Tachimori Y, Kato H, Watanabe H (2000) A case of small polypoid esophageal carcinoma with multidirectional differentiation, including neuroendocrine, squamous, ciliated glandular, and sarcomatous components. Arch Pathol Lab Med 124:1685–1687

    PubMed  CAS  Google Scholar 

  9. Li H, Walsh TN, O’Dowd G, Gillen P, Byrne PJ, Hennessy TP (1994) Mechanisms of columnar metaplasia and squamous regeneration in experimental Barrett’s esophagus. Surgery 115:176–181

    PubMed  CAS  Google Scholar 

  10. Lyda MH, Weiss LM (2000) Immunoreactivity for epithelial and neuroendocrine antibodies are useful in the differential diagnosis of lung carcinomas. Hum Pathol 31:980–987

    Article  PubMed  CAS  Google Scholar 

  11. McFadden DW, Rudnicki M, Talamini MA (1989) Primary small cell carcinoma of the esophagus. Ann Thorac Surg 47:477–480

    Article  PubMed  CAS  Google Scholar 

  12. Mitry E, Baudin E, Ducreux M, Sabourin JC, Rufie P, Aparicio T, Aparicio T, Lasser P, Elias D, Duvillard P, Schlumberger M, Rougier P (1999) Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin. Br J Cancer 81:1351–1355

    Article  PubMed  CAS  Google Scholar 

  13. Noguchi T, Uchida Y, Fumoto S, Wada S, Sato T, Takeno S (2002) Adenosquamous carcinoma arising in Barrett’s esophagus. Jpn J Thorac Cardiovasc Surg 50:537–540

    Article  PubMed  Google Scholar 

  14. Papotti M, Cassoni P, Sapino A, Passarino G, Krueger JE, bores-Saavedra J (2000) Large cell neuroendocrine carcinoma of the gallbladder: report of two cases. Am J Surg Pathol 24:1424–1428

    Article  PubMed  CAS  Google Scholar 

  15. Sarbia M, Becker KF, Hofler H (2004) Pathology of upper gastrointestinal malignancies. Semin Oncol 31:465–475

    Article  PubMed  Google Scholar 

  16. Saw EC, Yu GS, Wagner G, Heng Y (1997) Synchronous primary neuroendocrine carcinoma and adenocarcinoma in Barrett's esophagus. J Clin Gastroenterol 24:116–119

    Article  PubMed  CAS  Google Scholar 

  17. Shia J, Guillem JG, Moore HG, Tickoo SK, Qin J, Ruo L, Suriawinata A, Paty PB, Minsky BD, Weiser MR, Temple LK, Wong WD, Klimstra DS (2004) Patterns of morphologic alteration in residual rectal carcinoma following preoperative chemoradiation and their association with long-term outcome. Am J Surg Pathol 28:215–223

    Article  PubMed  Google Scholar 

  18. Shia J, Tickoo SK, Guillem JG, Qin J, Nissan A, Hoos A, Stojadinovic A, Ruo L, Wong WD, Paty PB, Weiser MR, Minsky BD, Klimstra DS (2002) Increased endocrine cells in treated rectal adenocarcinomas: a possible reflection of endocrine differentiation in tumor cells induced by chemotherapy and radiotherapy. Am J Surg Pathol 26:863–872

    Article  PubMed  Google Scholar 

  19. Takubo K, Nakamura K, Sawabe M, Arai T, Esaki Y, Miyashita M, Mafune K, Tanaka Y, Sasajima K (1999) Primary undifferentiated small cell carcinoma of the esophagus. Hum Pathol 30:216–221

    Article  PubMed  CAS  Google Scholar 

  20. Tateishi R, Taniguchi H, Wada A, Horai T, Taniguchi K (1974) Argyrophil cells and melanocytes in esophageal mucosa. Arch Pathol 98:87–89

    PubMed  CAS  Google Scholar 

  21. Tsubochi H, Suzuki T, Suzuki S, Ohashi Y, Ishibashi S, Moriya T, Fujimura S, Sasano H (2000) Immunohistochemical study of basaloid squamous cell carcinoma, adenoid cystic and mucoepidermoid carcinoma in the upper aerodigestive tract. Anticancer Res 20:1205–1211

    PubMed  CAS  Google Scholar 

  22. Wu Z, Ma JY, Yang JJ, Zhao YF, Zhang SF (2004) Primary small cell carcinoma of esophagus: report of 9 cases and review of literature. World J Gastroenterol 10:3680–3682

    PubMed  Google Scholar 

  23. Yachida S, Matsushita K, Usuki H, Wanibuchi H, Maeba T, Maeta H (2001) Long-term survival after resection for small cell carcinoma of the esophagus. Ann Thorac Surg 72:596–597

    Article  PubMed  CAS  Google Scholar 

  24. Yamamoto J, Ohshima K, Ikeda S, Iwashita A, Kikuchi M (2003) Primary esophageal small cell carcinoma with concomitant invasive squamous cell carcinoma or carcinoma in situ. Hum Pathol 34:1108–1115

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Centre Régional de Lutte Contre le Cancer Val d’Aurelle, 208 Rue des Apothicaires, 34298, Montpellier Cedex 5, France

    Frédéric Bibeau, Marie-Christine Chateau, Rosy Lavaill & Florence Boissière-Michot

  2. Centre de Pathologie, 2 Avenue des Palmiers, 66000, Perpignan, France

    Michel Guiu

  3. Department of Oncology, Centre Régional de Lutte Contre le Cancer Val d’Aurelle, Montpellier, France

    Eric Assenat, David Azria & Marc Ychou

Authors
  1. Frédéric Bibeau
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marie-Christine Chateau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michel Guiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eric Assenat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Azria
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rosy Lavaill
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marc Ychou
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Florence Boissière-Michot
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frédéric Bibeau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bibeau, F., Chateau, MC., Guiu, M. et al. Small cell carcinoma with concomitant adenocarcinoma arising in a Barrett’s oesophagus: report of a case with a favourable behaviour. Virchows Arch 452, 103–107 (2008). https://doi.org/10.1007/s00428-007-0533-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-007-0533-1

Keywords

Search

Navigation