Esophageal Collision Tumor (Large Cell Neuroendocrine Carcinoma and Papillary Carcinoma) Arising in a Barrett Esophagus

Wilson, Christopher L.; Summerall, Janna; Willis, Irvin; Lubin, Jack; Inchausti, Beria Cabello

doi:10.5858/2000-124-0411-ectlcn

Cited by 25 publications

(4 citation statements)

References 24 publications

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“…Identifying and differentiating light microscopic features of large cell neuroendocrine tumors (LCNET) from esophageal squamous cell carcinoma, adenocarcinoma is the most difficult diagnostic factor, since rosette-like structures, the best marker for recognition of neuroendocrine differentiation, can be confused with glandular formations, thereby erroneously misdiagnosing as poorly differentiated adenocarcinoma [ 8 , 10 , 14 ]. Similarly, more solid areas of the neoplasm may display squamoid morphologic findings, resulting in the diagnosis of poorly differentiated squamous cell carcinoma [ 10 , 14 ]. This misdiagnosis occurred in our case before the histology was reviewed and labeled correctly as LCNET [ 10 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to Yan et al, levels of NSE may be used as a prognostic factor in response to chemotherapy regimen of cisplatin and etoposide as patients with NSE levels below 17 respond more favorably to treatment [ 6 ]. Surgery has a limited role in the management of NETs given poor postoperative quality of life, high perioperative morbidity and mortality, and little survival benefit [ 2 , 6 , 7 , 14 ]. Minimally invasive transhiatal surgery is advised for early cancers of middle and lower esophagus, as well as patients unable to undergo thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

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Large-Cell Esophageal Neuroendocrine Tumor Leading to Hepatorenal Syndrome

Umar¹,

Ilyas²,

Otusile³

et al. 2022

Cureus

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Neuroendocrine tumors are tumors that arise from the enterochromaffin cells in the neuroendocrine tissue found throughout the body, particularly the digestive tract, pancreas, and thymus. Neuroendocrine tumors of the esophagus are extremely rare and highly aggressive in nature. We present the case of a 55-year-old Hispanic male who initially presented to the emergency department with right-sided abdominal pain. Imaging revealed innumerable lesions occupying half of the liver parenchyma. Subsequent endoscopy with biopsy of the esophageal and liver lesions along with immunohistochemistry staining was suggestive of a large cell neuroendocrine tumor. He later presented with generalized weakness and right-sided abdominal pain with worsening hepatic and renal function. Over the course of the patient's stay in the hospital, his mental status progressively deteriorated. Given the deranged hepatic and renal function, chemotherapy could not be initiated. The patient's family decided against hemodialysis considering his poor prognosis and the patient expired on day 15 of admission. The case report highlights the aggressiveness of one of the rare esophageal malignancies. It is crucial to establish diagnosis at the earlier stages of the disease with prompt treatment in order to avoid serious complications such as hepatorenal syndrome, which resulted in rapid deterioration of our patient's clinical status. More research is necessary in order to establish guidelines to treat neuroendocrine tumors of the esophagus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Large-Cell Esophageal Neuroendocrine Tumor Leading to Hepatorenal Syndrome

Umar¹,

Ilyas²,

Otusile³

et al. 2022

Cureus

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“…To date, 16 cases of esophageal collision cancer have been reported in the English literature (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). However, most previous reports on esophageal collision cancer described advanced cancer with tumor tissue invading the muscle layer, and all previously reported cases of esophageal collision cancer have been treated with radical surgical resection or palliative chemoradiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Case report: First case of early adenoid cystic carcinoma and squamous cell carcinoma collision cancer treated by endoscopic submucosal dissection

Zheng

Wei

et al. 2023

Front. Oncol.

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BackgroundCollision cancer, a rare tumor, rarely occurs in the esophagus. Most reported cases of esophageal collision cancers are advanced cancers that can only be treated with surgery or palliative chemoradiotherapy. Here, we report a rare case of collisional squamous cell carcinoma (SqCC) and adenoid cystic carcinoma (AdCC) that was detected in the early stages by endoscopy.Case summaryA 66-year-old man presented with retrosternal pain after swallowing and underwent endoscopy. Pathological biopsy showed high-grade squamous intraepithelial neoplasia. The lesion was removed by endoscopic submucosal dissection (ESD) after magnification and endoscopic ultrasonography. Postoperative pathology proved that the lesion was collision cancer comprising SqCC and AdCC. After six months of postoperative follow-up, there was no recurrence of esophageal cancer.ConclusionsWe provided a case report related to the diagnosis and treatment of esophageal collision cancer, especially early collision cancer. More research is needed to provide insights into the management of collision cancers.

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“…Microscopically, small cell-type ENEC has small cancer cells in similar sizes arranged in a row with unclear boundaries, and the nucleus is in round/short/spindle-like shape ( 3 ). Large cell-type ENEC has tumor cells with more than three-fold size as that of lymphocytes arranged in sheets/nests and less cytoplasm, and the nucleus is in round/oval/spindle-like shape ( 4 ). For imaging exams, in addition to ultrasound, computed tomography (CT), and magnetic resonance imaging, pathological slices dealt with immunohistochemistry (e.g., Ki-67 staining) can provide a precise diagnosis of ENEC ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Incidence, treatment, and survival analysis in esophageal neuroendocrine carcinoma population

Li¹,

Hu²,

Chen³

et al. 2020

Transl Cancer Res TCR

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Background As a subtype of esophageal neuroendocrine neoplasms (ENENs), esophageal neuroendocrine carcinoma (ENEC) is rare. ENEC can be poorly differentiated and highly aggressive. This study aims to illustrate the incidence, treatment, and prognosis of ENEC by using a population-based database. Methods We collected clinicopathological data [1975–2016] of ENEC, esophageal adenocarcinoma (EACA), and esophageal squamous cell carcinoma (ESqCC) from the Surveillance, Epidemiology and End Results (SEER) database, and analyzed their incidence, treatment, and prognosis. Results A total of 60,238 cases were in our study cohort, including ENEC (n=686), EACA (n=26,575), and ESqCC (n=32,977). The incidence of ENEC in 2016 was 0.044 per 100,000 persons. The tumor grade of ENEC was significantly higher than that of EACA and ESqCC (P<0.001). Both cancer-specific survival (CSS) and overall survival (OS) of ENEC were significantly worse than those of EACA and ESqCC (P<0.001). Kaplan-Meier analysis showed significant improvement of CSS and OS by surgery, radiotherapy, and chemotherapy (all P<0.001). Besides, compared with monotherapies, combinational therapies brought more benefits to both CSS and OS of patients with ENEC. Conclusions Our population-based evidence revealed that ENEC, as a rare cancer, had a worse prognosis, compared with EACA and ESqCC. Surgery, chemotherapy, and radiotherapy can all improve the prognosis of ENEC patients. Combinational therapy can yield a better prognosis than monotherapy.

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Esophageal Collision Tumor (Large Cell Neuroendocrine Carcinoma and Papillary Carcinoma) Arising in a Barrett Esophagus

Cited by 25 publications

References 24 publications

Large-Cell Esophageal Neuroendocrine Tumor Leading to Hepatorenal Syndrome

Large-Cell Esophageal Neuroendocrine Tumor Leading to Hepatorenal Syndrome

Case report: First case of early adenoid cystic carcinoma and squamous cell carcinoma collision cancer treated by endoscopic submucosal dissection

Incidence, treatment, and survival analysis in esophageal neuroendocrine carcinoma population

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