Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6478
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
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.
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.
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.
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.