Small Cell Carcinoma of the Esophagus: Report of a Case With Review of the Literature

Abstract

Primary small-cell carcinoma of the esophagus is a rare tumor that disseminates early and has a uniformly poor prognosis if untreated. We report on a patient with esophageal small-cell carcinoma treated with combination chemotherapy following surgical resection. A 48-year-old female had an ulcerated tumor in the distal part of the esophagus, which was microscopically diagnosed as esophageal small-cell carcinoma. Computed tomography (CT) of the chest and abdomen showed no lymphadenopathy or distant metastatic disease. Chemotherapy plus radiation therapy was planned but the patient refused the proposed treatment due to socieconomic reasons. Subsequently, subtotal esophagectomy with lymphadenectomy (3 periesophageal nodes) was performed in another hospital. The histopathologic diagnosis of the primary tumor was small-cell carcinoma and the resected lymph nodes also contained metastatic deposits. On the second postoperative month she was admitted with hepatic metastases. Combination chemotherapy with etoposide 120 mg/m2/day on days 1 to 3, and cisplatin 75mg/m2/day on day 1, given intravenously (i.v.) every 3 weeks was started. After 3 courses, the patient achieved complete remission. Esophageal small-cell carcinoma is an aggressive tumor. Patients with disseminated disease should receive combination chemotherapy along with symptomatic treatment.