A case report of small cell carcinoma of the esophagus successfully treated by irinotecan and cisplatin

Small cell carcinoma of the esophagus is regarded as having a poor prognosis with frequent and early recurrence against various treatments. We have experienced a case of small cell carcinoma of the esophagus manifested by massive lymph node metastasis in the upper mediastinum successfully treated by CPT-11 and CDDP, and that a patient survived for 17 months after the initial treatment. A 62-year-old man underwent endoscopy due to a disturbance of the food passage. Pathological evaluation of biopsy specimen revealed small cell carcinoma of the esophagus. As he was diagnosed with bilateral lymph node metastasis in the upper mediastinum by CT scan, a systemic chemotherapy with CPT-11 and CDDP was adopted. After 2 courses of chemotherapy he could be discharged as the size of the tumor was reduced. After 3 courses of additional chemotherapy 8 months after the initial treatment, a recurrent tumor was indicated at the right side of the lymph node of the neck. A weekly radiation with concurrent administration of docetaxel was carried out as a second line treatment. He is surviving for 17 months after the initial treatment without any evidence of recurrence. Due to histo-pathological similarity, a treatment for small cell carcinoma of the esophagus resembles that of the lung. Recently, the combined treatment of CPT-11 and CDDP was reported to demonstrate a better influence on a patient's survival for small cell carcinoma of the lung. For the esophagus, CPT-11 and CDDP was also an effective treatment.