A rare case of colliding cancer of the esophagus with small cell neuroendocrine, squamous, and adenocarcinoma components

Abstract

Esophageal cancer is one of the top ten prevalent cancers in the world with a poor prognosis, especially in advanced stages. The prevalent cell type is different according to the location: squamous cell carcinoma is the prevalent subtype in the proximal (upper) esophagus, while adenocarcinoma is more prevalent in lower/distal esophagus. Primary small cell carcinoma of the esophagus is rare in prevalence and only limited cases have been reported. We report a 62 year old female patient who was newly diagnosed of esophageal cancer and subsequently received surgical resection. Interestingly, the pathology from the resected esophageal lesion revealed a mixed histology type with small cell carcinoma , squamous cell carcinoma, and adenocarcinoma. Currently in the literature, a triple combined histology type cancer is rarely reported. The etiology is unclear, one possibility being multi-focal primary cancers, another being a collision of distinct primary cancers. This patient was started on postoperative CCRT and currently treatment is still ongoing. Our case presents with an interesting finding of triple cancer of the esophagus which contributes to medical knowledge and is valuable for oncologists encountering this rare scenario.