Early Adenocarcinoma Mixed with a Neuroendocrine Carcinoma Component Arising in the Gastroesophageal Junction: A Case Report

Overview

Journal World J Gastrointest Oncol

Publisher Baishideng Publishing Group

Date 2024 Mar 1

PMID 38425401

Authors

Yu-Qing Cheng

Geng-Fang Wang

Xiao-Li Zhou

Min Lin

Xin-Wen Zhang

Qin Huang

Affiliations

Soon will be listed here.

Abstract

Background: Early adenocarcinoma mixed with a neuroendocrine carcinoma (NEC) component arising in the gastroesophageal junctional (GEJ) region is rare and even rarer in young patients. Here, we report such a case in a 29-year-old Chinese man.

Case Summary: This patient presented to our hospital with a 3-mo history of dysphagia and regurgitation. Upper endoscopy revealed an elevated nodule in the distal esophagus 1.6 cm above the GEJ line, without Barrett's esophagus or involvement of the gastric cardia. The nodule was completely resected by endoscopic submucosal dissection (ESD). Pathological examination confirmed diagnosis of intramucosal adenocarcinoma mixed with an NEC component, measuring 1.5 cm. Immunohistochemically, both adenocarcinoma and NEC components were positive for P53 with a Ki67 index of 90%; NEC was positive for synaptophysin and chromogranin. Next-generation sequencing of 196 genes demonstrated a novel germline mutation of the gene in the DNA repair pathway and a germline mutation of the gene, a common gastric cancer driver gene, in addition to pathogenic somatic mutations in and genes. The patient was alive without evidence of the disease 36 mo after ESD.

Conclusion: Early adenocarcinoma with an NEC component arising in the distal esophageal side of the GEJ region showed evidence of gastric origin.

Citing Articles

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Shenoy S World J Gastrointest Oncol. 2024; 16(6):2295-2299.

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References

Dulak A, Stojanov P, Peng S, Lawrence M, Fox C, Stewart C . Exome and whole-genome sequencing of esophageal adenocarcinoma identifies recurrent driver events and mutational complexity. Nat Genet. 2013; 45(5):478-86. PMC: 3678719. DOI: 10.1038/ng.2591. View

Sun Q, Huang Q, Feng A, Fan X, Wu H, Mashimo H . Columnar-lined esophagus in Chinese patients with proximal gastric carcinomas. J Dig Dis. 2012; 14(1):22-8. DOI: 10.1111/1751-2980.12007. View

Juanmartinena J, Fernandez-Urien I, Cordoba A, Miranda C, Borda A . Mixed adenoneuroendocrine carcinoma (MANEC) of the gastroesophageal junction: a case report and review of the literature. Rev Esp Enferm Dig. 2016; 109(2):160-162. DOI: 10.17235/reed.2016.4315/2016. View

. Integrated genomic characterization of oesophageal carcinoma. Nature. 2017; 541(7636):169-175. PMC: 5651175. DOI: 10.1038/nature20805. View

Codipilly D, Sawas T, Dhaliwal L, Johnson M, Lansing R, Wang K . Epidemiology and Outcomes of Young-Onset Esophageal Adenocarcinoma: An Analysis from a Population-Based Database. Cancer Epidemiol Biomarkers Prev. 2020; 30(1):142-149. PMC: 7855414. DOI: 10.1158/1055-9965.EPI-20-0944. View

Hu N, Kadota M, Liu H, Abnet C, Su H, Wu H . Genomic Landscape of Somatic Alterations in Esophageal Squamous Cell Carcinoma and Gastric Cancer. Cancer Res. 2016; 76(7):1714-23. PMC: 4873357. DOI: 10.1158/0008-5472.CAN-15-0338. View

Miyaguchi K, Kawasaki T, Tashima T, Ryozawa S . Mixed neuroendocrine-non-neuroendocrine neoplasm arising from long-segment Barrett's esophagus showing exceptionally aggressive clinical behavior. Cancer Rep (Hoboken). 2022; 5(9):e1644. PMC: 9458485. DOI: 10.1002/cnr2.1644. View

Li M, Gao M, Xie X, Zhang Y, Ning J, Liu P . MicroRNA-200c reverses drug resistance of human gastric cancer cells by targeting regulation of the NER-ERCC3/4 pathway. Oncol Lett. 2019; 18(1):145-152. PMC: 6539893. DOI: 10.3892/ol.2019.10304. View

. Comprehensive molecular characterization of gastric adenocarcinoma. Nature. 2014; 513(7517):202-9. PMC: 4170219. DOI: 10.1038/nature13480. View

10.

Huang Q, Fan X, Agoston A, Feng A, Yu H, Lauwers G . Comparison of gastro-oesophageal junction carcinomas in Chinese versus American patients. Histopathology. 2011; 59(2):188-97. DOI: 10.1111/j.1365-2559.2011.03924.x. View

11.

Dubecz A, Solymosi N, Stadlhuber R, Schweigert M, Stein H, Peters J . Does the Incidence of Adenocarcinoma of the Esophagus and Gastric Cardia Continue to Rise in the Twenty-First Century?—a SEER Database Analysis. J Gastrointest Surg. 2013; 18(1):124-129. DOI: 10.1007/s11605-013-2345-8. View

12.

Oezcelik A, Ayazi S, DeMeester S, Zehetner J, Abate E, Dunn J . Adenocarcinoma of the esophagus in the young. J Gastrointest Surg. 2013; 17(6):1032-5. DOI: 10.1007/s11605-013-2177-6. View

13.

Maru D, Khurana H, Rashid A, Correa A, Anandasabapathy S, Krishnan S . Retrospective study of clinicopathologic features and prognosis of high-grade neuroendocrine carcinoma of the esophagus. Am J Surg Pathol. 2008; 32(9):1404-11. DOI: 10.1097/PAS.0b013e31816bf41f. View

14.

Kawazoe T, Saeki H, Edahiro K, Korehisa S, Taniguchi D, Kudou K . A case of mixed adenoneuroendocrine carcinoma (MANEC) arising in Barrett's esophagus: literature and review. Surg Case Rep. 2018; 4(1):45. PMC: 5940966. DOI: 10.1186/s40792-018-0454-z. View

15.

Wang S, Zheng R, Arnold M, Abnet C, Zeng H, Zhang S . Global and national trends in the age-specific sex ratio of esophageal cancer and gastric cancer by subtype. Int J Cancer. 2022; 151(9):1447-1461. PMC: 9541383. DOI: 10.1002/ijc.34158. View

16.

Liu S, Dai J, Yao L, Li X, Reid B, Self S . Esophageal Adenocarcinoma and Its Rare Association with Barrett's Esophagus in Henan, China. PLoS One. 2014; 9(10):e110348. PMC: 4198241. DOI: 10.1371/journal.pone.0110348. View

17.

Doi S, Matsumoto S, Wakatsuki K, Migita K, Ito M, Kunishige T . A neuroendocrine carcinoma with a well-differentiated adenocarcinoma component arising in Barrett's esophagus: a case report and literature review. Surg Case Rep. 2018; 4(1):103. PMC: 6115318. DOI: 10.1186/s40792-018-0511-7. View

18.

Kaneko Y, Saito S, Takahashi K, Kanamaru R, Hosoya Y, Yamaguchi H . Neuroendocrine carcinoma of the esophagus with an adenocarcinoma component. Clin J Gastroenterol. 2019; 12(6):534-538. DOI: 10.1007/s12328-019-00995-7. View

19.

Stradella A, Del Valle J, Rofes P, Vargas-Parra G, Salinas M, Gonzalez S . ERCC3, a new ovarian cancer susceptibility gene?. Eur J Cancer. 2020; 141:1-8. DOI: 10.1016/j.ejca.2020.09.023. View

20.

Huang J, Koulaouzidis A, Marlicz W, Lok V, Chu C, Ngai C . Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries. Cancers (Basel). 2021; 13(1). PMC: 7795486. DOI: 10.3390/cancers13010141. View