The most frequent presentation of esophageal cancer is adenocarcinoma and squamous cell carcinoma. In recent years, the latter has decreased its incidence increasing the adenocarcinoma. Currently, another type of tumor with a much lower incidence has been described, which has a neuroendocrine component along with another exocrine glandular component and has been classified since 2010 as mixed adenoneuroendocrine carcinoma (MANEC). We present the case of a 68-year-old male with a history of dyspepsia and epigastric pain who after performing a gastroscopy, was diagnosed with a malignant neoplasm of the esophagus. The patient underwent a total esophagectomy with reconstruction by tubular gastroplasty with cervical anastomosis. The final result of the piece after immunohistochemistry revealed that the tumor was composed of one component of adenocarcinoma in 60% together with another component compatible with neuroendocrine in 40%. With these findings and according to the World Health Organization classification of 2010 was diagnosed as esophageal MANEC. MANECs are rare tumors, described in other locations of the digestive tract, the esophagus being an infrequent location. Its preoperative diagnosis is difficult, and it is not until the final analysis of the complete piece by means of specific immunohistochemical techniques when its diagnosis can be established. Its treatment is fundamentally surgical, whereas the adjuvant therapeutic schemes with chemotherapy are not well defined at present because of their low incidence.

Introduction: COVID-19 infection has spread throughout the world and is considered a pandemic. Since its appearance, the number of non-COVID-19 patients admitted to hospitals has decreased and patients differ care for emergency diseases. We analyze the impact of the SARS-CoV-2 coronavirus pandemic on the management of acute cholecystitis. Material and methods: Retrospective observational study that includes all patients diagnosed with acute cholecystitis during the SARS-CoV-2 coronavirus pandemic (period between March 11th and June 21st, 2020) and patients diagnosed with acute cholecystitis in the same period, the previous year in our center. Patient’s features, management, postoperative complications and mean hospital stay were compared. Results: In 2020, 19 patients with acute cholecystitis were diagnosed compared to 21 who were registered in the same period in 2019. The mean number of days from symptoms onset in 2020 was 2.42±1.8 days, while in 2019 it was 3.5±3.1 days (p=0.32). The percentage of cholecystectomies, percutaneous cholecystostomies and conservative management was similar in both periods. Among patients who underwent cholecystectomy in 2020, 37.5% had no complications, 62.5% had accidental opening of the gallbladder, and none had bleeding. Among patients who underwent cholecystectomy in 2019, 81.8% had no complications, 9.09% had accidental opening of the gallbladder, and 9.09% presented bleeding. The mean stay in 2020 was 4.21±3.2 days, compared to 8.57±7.4 days in 2019 (p=0.005). Two patients of 19 diagnosed with acute cholecystitis in 2020 had COVID-19 disease. Conclusion: The mean stay of the patients was shorter in 2020 period. These results can be explained by an early surgical management. So, early laparoscopic cholecystectomy should be considered as a treatment for acute cholecystitis in COVID-19 times if the clinical and hospital situation allows it. We found no differences in the number of patients diagnosed with acute cholecystitis between the two periods, nor in the mean number of days from the onset of symptoms.

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