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Published on: August 14, 2012
Esophageal neuroendocrine tumor with initial presentation as painless forehead and neck masses: A case report
Yen-Po Chin1, Wei-Fu Lai, Meng-Ting Chiang
1Faculty of Medicine, National Yang-Ming University, Taipei Division of Chest Medicine, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan.
Rationale:
Esophageal neuroendocrine tumors (NETs) are a rare type of esophageal tumor which are usually positive for chromogranin A, synaptophysin, and CD56 in tumor immunohistochemical staining. The most common symptoms of esophageal NETs are gastrointestinal symptoms such as dysphagia and/or abdominal discomfort. While esophageal NETs have the potential for distant metastasis, there have only been a few reports of brain metastasis originating from esophageal NET.
Patient Concerns:
We report the case of a 60-year-old Taiwanese female who initially presented with a 1 month history of painless forehead and bilateral neck masses. She did not complain of any other symptoms, which complicated the diagnosis.
Diagnoses:
Chest and abdominal computed tomography were arranged for a thorough evaluation, and a paraesophageal lesion as well as multiple metastases in the liver, bilateral adrenal glands, and bone were found. Panendoscopy and pathology confirmed the diagnosis of an esophageal NET.
Interventions:
Best supportive care.
Outcomes:
The clinical course of this case deteriorated drastically, and she died of tumor progression 10 days after the diagnosis had been made.
Lessons:
To the best of our knowledge, this is the first article in the literature to report a case of esophageal NET whose initial presentation was painless forehead and bilateral neck masses. Clinicians should be aware of the early signs and symptoms of esophageal NET to allow for a prompt diagnosis.
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