[A clinicopathological study of small-cell esophageal carcinoma]

Small-cell esophageal carcinoma (SCEC) is not uncommon. From 1979 through 1994, 42 cases of SCEC were diagnosed among 711 patients with cancer of the esophagus, with a relative frequency of 5.9%. Differential diagnosis is difficult according to clinical symptoms and signs. However, SCEC differs greatly from squamous-cell carcinoma of the esophagus in histopathology and biologic behavior but is similar to small-cell lung cancer (SCLC). Surgical treatment alone of SCEC patients has a mean survival period of 11.2 months while patients treated with radiotherapy alone has a longer survival (22.8 months). No case was treated only with chemotherapy in this group of patients. Those received no treatment could survive 6.2 months only. Therefore, SCEC is a very aggressive tumor with poor prognosis. Histochemical and immunohistochemical study revealed both epithelial and neuro-endocrine differentiation potentials suggesting that SCEC probably originates from mulfipotential primitive stem cells in the esophageal mucosa.