Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6478-6484
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6478
Primary small cell esophageal carcinoma, chemotherapy sequential immunotherapy: A case report
Yong-Hui Wu, Kai Zhang, Hui-Guo Chen, Wei-Bin Wu, Xiao-Jun Li, Jian Zhang
Yong-Hui Wu, Kai Zhang, Wei-Bin Wu, Xiao-Jun Li, Jian Zhang, Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Hui-Guo Chen, Department of Thoracic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Wu YH designed the report and wrote the paper; Zhang K, Chen HG and Wu WB collected the patient’s medical imaging materials; Li XJ and Zhang J participated in the revision of this article.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Zhang, PhD, Assistant Professor, Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China. sumszhangjian@163.com
Received: April 2, 2021
Peer-review started: April 2, 2021
First decision: April 28, 2021
Revised: May 16, 2021
Accepted: June 1, 2021
Article in press: June 1, 2021
Published online: August 6, 2021
Processing time: 116 Days and 14.9 Hours
Abstract
BACKGROUND

Primary small cell esophageal carcinoma (PSCEC) is aggressive and rare, with a worse prognosis than other subtypes esophageal carcinoma. No definitive and optimum standard guidelines are established for treating it. Herein, we report a case of PSCEC, including a current literature review of PSCEC.

CASE SUMMARY

A 79-year-old male was diagnosed PSCEC with multiple lymph node metastasis thorough computed tomography, positron emission tomography-computed tomography, endoscopy and pathology. Surgery was not suitable for this patient. He was treated with etoposide 100 mg/m2 and cisplatin 25 mg/m2 on days 1-3, every 3 wk for 4 cycles. The tumor and lymph nodes became smaller and dysphagia and vomiting symptoms improved. The patient could not tolerate subsequent chemotherapy (CT) because of hematological toxicity; therefore, we performed immunotherapy (durvalumab, 1500 mg) every 4 wk. At present the patient has received 12 cycles immunotherapy over about 1 year. He is still receiving treatment and follow-up.

CONCLUSION

PSCEC with multiple lymph nodes metastasis does not always indicate surgery. CT may extend survival time and improve the quality of life in the absence of surgery. Immunotherapy or immunotherapy plus CT may also work as a treatment for PSCEC.

Keywords: Primary small cell esophageal carcinoma; Diagnosis; Chemotherapy; Immunotherapy; Case report

Core Tip: A 79-year-old male was diagnosed primary small cell esophageal carcinoma and multiple lymph nodes metastasis thorough computed tomography, positron emission tomography-computed tomography, endoscopy and pathology. Surgery was not suitable for this patient. Instead, he was treated with etoposide and cisplatin chemotherapy regiment, every 3 wk for 4 cycles, which caused the tumor and lymph nodes to shrink. The patient could not tolerate subsequent chemotherapy due to hematological toxicity; therefore, we performed immunotherapy (durvalumab, 1500 mg) every 4 wk. At present, the patient has received 12 cycles immunotherapy over about 1 year and continues treatment and follow-up.