Clinical Gastroenterology Vol.21 No.10(2)

Theme Neuroendocrine Tumor of the Gastrointestinal Tract
Title Small Cell Carcinoma of the Esophagus : Pathomorphology, Diagnosis and Therapy
Publish Date 2006/09
Author Kaiyo Takubo Research Team for Geriatric Diseases, Tokyo Metropolitan Institute of Gerontology, Tokyo Metropolitan Geriatric Hospital
Author Naoko Honma Research Team for Geriatric Diseases, Tokyo Metropolitan Institute of Gerontology, Tokyo Metropolitan Geriatric Hospital
Author Junko Aida Research Team for Geriatric Diseases, Tokyo Metropolitan Institute of Gerontology, Tokyo Metropolitan Geriatric Hospital
Author Tomio Arai Department of Pathology, Tokyo Metropolitan Geriatric Hospital
Author Ichiro Kasahara Department of Pathology, Tokyo Metropolitan Geriatric Hospital
Author Motoji Sawabe Department of Pathology, Tokyo Metropolitan Geriatric Hospital
Author Miwako Arima Department of Internal Medicine, Saitama Cancer Center
[ Summary ] The incidence of small cell carcinoma is about 1 - 2 % of all esophageal malignancies in Japan. Here we review the clinicopathologic features of esophageal small cell carcinoma and discuss the urgency of establishing an effective treatment. The Predominantly Subepithelial Type in the Endoscopic and Macroscopic Classifications (defined in the Guidelines for Clinical and Pathologic Study of Carcinoma of the Esophagus) very frequently shows special histologic types (including small cell carcinoma) other than squamous cell carcinoma. Small cell carcinoma of the esophagus is subdivided histopathologically into the pure, combined and mixed types, but the significance of this subclassification has not been established. At biopsy diagnosis, the combined subtype has features of other carcinoma types, such as squamous cell carcinoma, and therefore small cell carcinomas are often overlooked or misdiagnosed because the biopsy specimen may not contain small cell carcinoma components. When there is discrepancy between the endoscopic and histologic diagnoses, close discussion about the diagnosis is needed between clinicians and pathologists. NSE is used as a marker for monitoring the treatment of small cell carcinoma. Patients with small cell carcinoma of the esophagus have a very poor prognosis, and multi-institutional studies to establish an effective treatment are urgently required.
back