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食管大细胞神经内分泌癌积极治疗的病例报告。

Case report of aggressive treatments for large-cell neuroendocrine carcinoma of the esophagus.

作者信息

Nakao Yosuke, Okino Tetsuya, Yamashita Yo-Ichi, Taki Katsunobu, Nakagawa Shigeki, Matsumoto Katsutaka, Goto Mataro, Baba Hideo

机构信息

Department of Surgery, National Hospital Organization Miyakonojo Medical Center, Miyazaki, Japan; Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.

Department of Surgery, National Hospital Organization Miyakonojo Medical Center, Miyazaki, Japan.

出版信息

Int J Surg Case Rep. 2019;60:291-295. doi: 10.1016/j.ijscr.2019.06.056. Epub 2019 Jun 28.

Abstract

INTRODUCTION

Neuroendocrine carcinoma of the esophagus is a rare and highly aggressive disease, and the biological features are poorly understood.

PRESENTATION OF CASE

We report a case of large-cell neuroendocrine carcinoma of the esophagus in a 73-year-old male patient with aggressive surgical treatment. Upper gastrointestinal endoscopy revealed an esophageal large mass. Histological examination of biopsy specimens indicated a neuroendocrine carcinoma. First, we performed subtotal esophagectomy with lymphadenectomy, but he experienced metastasis at the liver and rib 5 months later. Next, we performed partial hepatectomy and radiotherapy for rib metastasis, but he experienced metastasis at the left pulmonary hilar lymph node and sacral bone. Finally, we performed chemotherapy using cisplatin and irinotecan.

DISCUSSION

The therapeutic strategy for large-cell NEC of the esophagus is unestablished. Thus, accumulating the therapeutic results garnered from various treatment tools is considerably important.

CONCLUSION

Aggressive multimodal treatments including surgery have a possibility to gain better survival in patients with large-cell NEC of the esophagus.

摘要

引言

食管神经内分泌癌是一种罕见且侵袭性很强的疾病,其生物学特性尚不清楚。

病例介绍

我们报告一例73岁男性食管大细胞神经内分泌癌患者,接受了积极的手术治疗。上消化道内镜检查发现食管有一个大肿块。活检标本的组织学检查显示为神经内分泌癌。首先,我们进行了食管次全切除术及淋巴结清扫术,但5个月后他出现了肝和第5肋骨转移。接下来,我们对肋骨转移灶进行了部分肝切除术和放疗,但他又出现了左肺门淋巴结和骶骨转移。最后,我们使用顺铂和伊立替康进行了化疗。

讨论

食管大细胞神经内分泌癌的治疗策略尚未确立。因此,积累各种治疗手段的治疗结果非常重要。

结论

包括手术在内的积极多模式治疗有可能使食管大细胞神经内分泌癌患者获得更好的生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ab8/6609733/8533adb78db2/gr1.jpg

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