Wen Danxia, Wang Xiaoyang, Luo Min, Yan Hengchen
Department of Radiation Oncology, Center for Cancer Prevention and Treatment, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences Meizhou 514031, Guangdong, China.
Am J Transl Res. 2025 Apr 15;17(4):3247-3251. doi: 10.62347/TBQW3054. eCollection 2025.
Esophageal large-cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive malignancy that presents diagnostic and therapeutic challenges. We present the case of a 72-year-old female with LCNEC of the distal esophagus who was initially treated with chemotherapy and radiation therapy, followed by immunotherapy due to disease progression. Diagnostic imaging revealed extensive metastases to the abdominal lymph nodes. Histopathological examination confirmed the diagnosis of LCNEC with high-grade squamous intraepithelial neoplasia. The treatment complexities underscore the necessity of a multidisciplinary approach involving medical oncologists, radiation oncologists, and pathologists. While chemotherapy remains the standard, the role of immunotherapies, such as Slurilizumab in LCNEC management is evolving. Subsequent imaging revealed gradual tumor reduction, and the patient was maintained on immunotherapy. The patient has remained on immunotherapy since then, with a progression-free survival of 1 year and 4 months as of the latest follow-up, approximately 3 years post-diagnosis. This case highlights the potential of combining immunotherapy with conventional treatments for disease control. Further research is crucial to optimizing therapeutic strategies and prognostic factors for esophageal LCNEC to enhance clinical outcomes and patient care.
食管大细胞神经内分泌癌（LCNEC）是一种罕见且侵袭性强的恶性肿瘤，在诊断和治疗方面都面临挑战。我们报告一例72岁女性远端食管LCNEC病例，该患者最初接受化疗和放疗，后因疾病进展接受免疫治疗。诊断性影像学检查显示广泛转移至腹部淋巴结。组织病理学检查确诊为LCNEC合并高级别鳞状上皮内瘤变。治疗的复杂性凸显了多学科方法的必要性，该方法涉及医学肿瘤学家、放射肿瘤学家和病理学家。虽然化疗仍是标准治疗方法，但免疫疗法（如斯鲁利单抗）在LCNEC治疗中的作用正在不断演变。后续影像学检查显示肿瘤逐渐缩小，患者继续接受免疫治疗。此后患者一直接受免疫治疗，截至最新随访，即诊断后约3年，无进展生存期为1年4个月。该病例突出了免疫疗法与传统治疗相结合控制疾病的潜力。进一步的研究对于优化食管LCNEC的治疗策略和预后因素以改善临床结局和患者护理至关重要。
