A rare case of an esophageal neuroendocrine carcinoma arising on an endoscopic resection scar

Autores da FMUP

• Mário Jorge Dinis Ribeiro

  Autor

• Diogo Miguel Pereira Libânio Monteiro

  Autor

Participantes de fora da FMUP

• Ortigao, Raquel
• Isidoro, Raquel

Unidades de investigação

• Medicina da Comunidade, Informação e Decisão em Saúde

Abstract

Here we report a case of a 61-year-old woman who underwent en-bloc endoscopic submucosal dissection (ESD) of a 10mm depressed lesion (Paris 0-IIc, Figure A) in the mid-esophagus. Histopathology showed a lesion with high-grade squamous dysplasia (R0). On follow-up endoscopy at 6 and 12 months the scar was regular, without signs of recurrence. Seven months after the last endoscopy, the patient presented with chest pain and dysphagia. Endoscopy showed an ulcero-vegetating tumor with 3cm at the same location of previous ESD (Figure B), and biopsies showed a poorly differentiated small cell neuroendocrine carcinoma (NEC). Subsequent computed tomography identified peri-tumor and hilar lymph nodes, and an extensive periceliac nodal conglomerate adherent to the liver (stage IV). This is, to our knowledge, the first case described of esophageal NEC arising on the endoscopic resection scar.

Keywords

• Crohn's disease; Mucosal healing; Transmural healing; Ileocolonoscopy; Magnetic resonance; Intestinal ultrasound