Undifferentiated Carcinoma of the Esophagus with Rapid Growth of Lymph Node. A Case Report and Review of the Literature

Abstract

We present a case of undifferentiated carcinoma of the esophagus (UCE) treated with chemotherapy consisting of 5-fluorouracil plus nedaplatin and radiotherapy. The patient developed rapid growth of lymph nodes and died of massive hematemesis 2 months after the diagnosis. UCE is rare but highly malignant. Since there is no established treatment for UCE, its clinical outcome is invariably poor. We also reviewed the effectiveness of chemotherapy against UCE.

Complete and Sustained Objective Response per RECIST to Irvalec (PM02734) in Undifferentiated Large Cell Esophageal Adenocarcinoma: A Case Report and a Review of the Literature

“…Of note, no cumulative toxicities were reported in this long time period. Survival in previous cases reported in Japan varied from 10 months to 4 years; many of them were reported from time of palliative surgery [13, 14]. In the current case, survival from diagnosis was longer than 7 years, 5 of them after having received chemotherapy with Irvalec.…”

“…The incidence reported in Japan (1%) [14] agreed with that aforementioned in United States or Europe [4, 5, 10], but more information on disease and treatment was provided. Some of these cases described metastatic lesions in lower paraesophageal lymph nodes [13], or in gastric body lymph nodes and liver [14]. Indeed, some authors described undifferentiated non-small cell esophageal carcinoma as highly malignant due to rapid tumor progression and distant metastasis [14].…”

“…Previous case reports in Japan on patients with undifferentiated carcinomas treated with 5-FU plus cisplatin or 5-FU plus nedaplatin have shown only partial responses ranging from 2 to 61 months [14]. Our patient received Irvalec, a novel investigational agent, administered as fourth chemotherapy line.…”

“…This entity has been more recognized in studies conducted in Japan, where some published reports described cases of undifferentiated ‘non-small cell’ carcinoma of the esophagus [12, 13, 14, 15]. The incidence reported in Japan (1%) [14] agreed with that aforementioned in United States or Europe [4, 5, 10], but more information on disease and treatment was provided.…”

“…Some of these cases described metastatic lesions in lower paraesophageal lymph nodes [13], or in gastric body lymph nodes and liver [14]. Indeed, some authors described undifferentiated non-small cell esophageal carcinoma as highly malignant due to rapid tumor progression and distant metastasis [14]. Reinforcing this, other authors concluded that this type of undifferentiated carcinoma is difficult-to-treat, with a poor outcome, and that further studies on additional cases are required to clarify the clinical and pathological significance of this rare tumor in the esophagus [13, 14].…”