Jacobs Journal of Clinical Case Reports

Collision Carcinoma of the Oesophago-Gastric Junction

*Etienne Abel
Department Of Surgery, Malta

*Corresponding Author:
Etienne Abel
Department Of Surgery, Malta
Email:jeabela@hotmail.com

Published on: 2018-06-09

Abstract

This case report describes a 60-year-old male with a collision carcinoma of the oesophago-gastric junction. Collision carcinoma (CC) is the synchronous occurrence of tumours of different histological type arising in the same organ without histological admixture. CC’s are rare clinical entities, especially at the oesophago-gastric junction. The CC in this case report was composed of moderately differentiated adenocarcinoma and poorly differentiated neuroendocrine carcinoma.

Keywords

Collision Carcinoma; Adenocarcinoma; Neuroendocrine Carcinoma; Oesophagus; Oesophago-Gastric Junction

Introduction

A 60-year-old previously healthy presented with a 3 months’ history of progressive dysphagia. The patient was investigated with a flexible oesophago-gastro-duodenoscopy which identified a 15cm extensive and circumferential Type 2 Siewert cancer of the oesophago-gastric junction which just allowed endoscope passage. Biopsies from the lesion were in keeping with a Grade III invasive adenocarcinoma. Staging CT scan of the neck and trunk confirmed a large lesion as described at endoscopy. A staging laparoscopy was performed confirming a bulky junctional cancer which was, however, mobile at the hiatus. The peritoneal and liver surfaces were clear and peritoneal cytology was unremarkable. PET-CT scan (Figure 1) confirmed an FDG-avid junctional primary with no evidence of distant metastatic spread. The patient was informed that he had a large and locally advanced tumour which was borderline curable with surgery in addition to pre- and post-operative chemotherapy