Esophageal Neuroendocrine Carcinoma With Pathological Complete Response After Neoadjuvant Chemotherapy Followed by Robot-assisted Surgery: A Case Report

Background/aim: Malignant esophageal neuroendocrine carcinoma (ENEC) is rare, and its prognosis is poor. Therefore, a standard strategy for treating ENEC remains controversial, and few reports have described a pathological complete response of ENEC to neoadjuvant chemotherapy (NAC) followed by surgery.

Case report: A 74-year-old woman presented with an esophageal tumor, discovered as a result of dysphagia, that was clinically diagnosed as ENEC (small-cell type). The clinical stage was cT2N1M0 stage II (Union for International Cancer Control, eighth edition). Two cycles of carboplatin and etoposide were administered as NAC, and the overall treatment response to NAC was judged as a partial response according to Response Evaluation Criteria for Solid Tumors v.1.1. The patient then underwent robot-assisted, minimally-invasive esophagectomy with thoracoabdominal lymph node dissection. Postoperative histopathology revealed no residual tumor or lymph node metastasis, and pathological complete response to NAC was achieved. The postoperative course was free of major complications, and the patient has remained recurrence-free for 1 year.

Conclusion: We treated ENEC with NAC and robotic surgery. To our knowledge, this is the first report of a pathological complete response for ENEC after NAC with carboplatin and etoposide.