Long-surviving case of advanced esophageal small cell carcinoma with a multidisciplinary treatment approach

Abstract

A 64-year-old man presented with dysphagia and heartburn. Upper gastrointestinal endoscopy showed an irregular type 2 tumor of the lower esophagus. Histological examination of the biopsy specimen revealed undifferentiated carcinoma, small cell type. Subtotal esophagectomy was performed. Two months after the initial surgery, an intradural extramedullary metastasis was found, and tumorectomy was performed. Eight months after the initial surgery, lymph node metastases were found, and alternate-week administration of CPT-11 was begun. Thirteen months after the initial surgery, an oropharyngeal metastasis was identified for which he received radiation therapy with a total dose of 45 Gy. One month later, abdominal CT scan showed multiple liver metastases and a left adrenal metastasis. He received CPT-11 for another 12 months, but eventually succumbed to his disease 30 months after the initial diagnosis. Our case suggests that controlling each of the recurrent lesions with various treatment modalities might lead to prolonged survival.