Small cell carcinoma of the esophagus: clinical pathologic study of two cases

Background- Small-cell Carcinoma of the Esophagus is a rare tumor, aggressive, and morphologically indistinguishable from its correspondent well-known tumor in the lung. Aim - To present the clinical-pathological aspects of two patients presenting small-cell carcinoma of the esophagus. Cases report - Patient 1-a 55-year-old man presenting progressive dysphagia for 6 months, weight loss, and previous smoking and alcohol abuse history. Endoscopy showed a polypoid lesion, located 30 to 40 cm from the superior arcade. Anatomopathological analysis revealed undifferentiated small-cell carcinoma and positive immunohistochemical staining for neuroendocrine markers, including chromogranin and synaptophysin. The patient presented dysphagia remission after two cycles of chemotherapy (cisplatin and etoposide) and radiotherapy. Patient 2 - a 55-year-old man complaining pirosis, dysphagia, and hoarseness for 6 months, associated to a 10 kg weight loss. Endoscopy showed an obstructive polypoid lesion located 30 cm from the superior dental arcade. Anatomopathological study revealed small-cell carcinoma and positive immunohistochemical staining for neuroendocrine tumor. Computed tomography showed liver metastases. Considering the advanced stage of the tumor, gastrostomy was performed. The patient developed pneumonia and died within two months. Conclusion - The evolution of patients presenting small-cell carcinoma of the esophagus depends on the tumor staging. Despite of its aggressiveness, the respective tumor responds positively to combined chemo-radiotherapy.