Kitagawa Hiroyuki, Akimori Toyokazu, Namikawa Tsutomu, Okino Tomoko, Kobayashi Michiya, Nishioka Akihito, Hanazaki Kazuhiro
Dept. of Surgery 1, Kochi Medical School.
Gan To Kagaku Ryoho. 2009 Oct;36(10):1737-9.
Small cell carcinoma of the esophagus is rare, with a poor prognosis, and there is currently no standard therapy. Here we report a case of small cell carcinoma of the esophagus with right supraclavicular lymph node metastasis which was successfully treated by chemoradiotherapy. A 55-year-old man was admitted to our hospital with a right-sided neck tumor. The neck tumor was diagnosed as a small cell carcinoma by aspiration cytology. Endoscopy revealed an irregular tumor in the middle thoracic esophagus, 31 cm from the upper incisor teeth, but malignant cells were not detected from an esophageal biopsy. Right supraclavicular lymph node metastasis was detected by computed tomography and positron emission tomography computed tomography, and aspiration cytology revealed small cell undifferentiated carcinoma cells. The patient was diagnosed with a small cell carcinoma of the esophagus with supraclavicular lymph node metastasis, stage III: T2N3M0. Concurrent chemoradiotherapy using 5-fluorouracil and cisplatin was started. Lymph node reduction occurred from day 3, and endoscopy two months after chemoradiotherapy showed only a scar. We diagnosed the patient in complete remission, and he continues to do well with a recurrence-free status of 14 months after initial chemoradiotherapy.
食管小细胞癌罕见，预后较差，目前尚无标准治疗方法。在此我们报告一例伴有右锁骨上淋巴结转移的食管小细胞癌患者，经放化疗成功治愈。一名55岁男性因右侧颈部肿物入院。颈部肿物经穿刺细胞学检查诊断为小细胞癌。内镜检查发现胸段食管中段距上切牙31 cm处有一不规则肿物，但食管活检未检测到恶性细胞。计算机断层扫描和正电子发射断层扫描计算机断层扫描检测到右锁骨上淋巴结转移，穿刺细胞学检查显示为小细胞未分化癌细胞。该患者被诊断为伴有锁骨上淋巴结转移的食管小细胞癌，Ⅲ期：T2N3M0。开始使用5-氟尿嘧啶和顺铂进行同步放化疗。从第3天起淋巴结开始缩小，放化疗两个月后内镜检查仅显示瘢痕。我们诊断该患者完全缓解，初始放化疗后14个月无复发，状况良好。
