Small cell carcinoma of the oesophagus: a rare cause of dysphagia.

Primary small cell carcinoma of the oesophagus is a rare, highly aggressive malignancy with diagnosis usually occurring at the most advanced stages. We report a case of small cell carcinoma of the oesophagus presenting with dysphagia and melena. A 79-year-old Caucasian man presented to an outside hospital with dizziness, light-headedness, chest pain and melena for 3 days. He had a history of intermittent dysphagia for solids and a 25-pound weight loss in the past 2 months. He underwent an esophagogastroduodenoscopy that revealed a large polypoid, well-circumscribed friable oesophageal mass causing near complete obstruction of the lumen. This mass extended into the gastric cardia. Oesophageal biopsies were consistent with small cell neuroendocrine carcinoma. He underwent chemotherapy with subsequent remission and developed recurrence of disease in the oesophagus 2 years later. Overall, the patient has had two recurrences of his disease but has survived for more than 2 years with chemotherapy alone.