Korean J Gastroenterol.  2020 Apr;75(4):207-211. 10.4166/kjg.2020.75.4.207.

A Collision Tumor of the Esophagus: Mixed Squamous Cell Carcinoma and Neuroendocrine Carcinoma

• Choe AR
• Shim KN
• Lim J
• Song EM
• Tae CH
• Jung SA
• Jo MS

• KMID: 2504237
• DOI: http://doi.org/10.4166/kjg.2020.75.4.207

Abstract

Collision tumors are extremely rare, and currently, no therapeutic protocols are established. A 64-year-old man presented to his physician with complaints of right chest and abdominal pain. The contrast-enhanced CT scan showed a mass measuring 3.6 cm around the gastric fundus. Esophagogastroduodenoscopy was performed and a semicircular longitudinal ulcerative mass was found at the distal esophagus. A mass measuring about 4 cm with central ulceration was noted at the cardia. The esophageal biopsy revealed positivity for a component of neuroendocrine carcinoma adjacent to a squamous cell carcinoma. PET-CT revealed a mass in the esophagus and cardia and several tumors in the whole liver, pancreas, and bone. The patient was finally diagnosed with a collision tumor of the esophagus with multiple metastases. In conclusion, patients with collision tumors must undergo active multidisciplinary management that will include pathologists and oncologists, who will decide on proper treatment strategies.

Keyword

Esophageal neoplasms; Carcinoma; Neuroendocrine tumors

Figure

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  Fig. 1 Abdominal computed tomography findings. (A) About a 3.6 cm mass around the gastric fundus portion and also liver metastasis. (B) Multiple bone metastasis in the vertebra and sacrum.

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  Fig. 2 Endoscopic images of the esophageal neoplasm. (A, B) A semicircular longitudinal ulcerative mass at the distal esophagus. (C) About a 4 cm sized subepithelial mass with central ulceration at the fundus.

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  Fig. 3 Positron emission tomography-computed tomography findings. (A-C) A hypermetabolic lesion in the esophagus and cardia, and several tumors in the whole liver, pancreas, and bone.

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  Fig. 4 Histologic features of the esophagus specimen. (A) The positive for the component of the neuroendocrine carcinoma adjacent to a squamous carcinoma without intermigling (H&E, ×400). (B) Strong staining of p63 (+) for the squamous carcinoma cells (Immunohistochemical staining, ×400). (C) Strong staining of CD56 (+) for the neuroendocrine carcinoma cells (Immunohistochemical staining, ×400).

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