Jonathan Vincent M. Reyes
Icahn School of Medicine at Mount Sinai at Elmhurst Hospital Center
The rarity of neuroendocrine tumors and their ability to manifest in many different organs often makes diagnosis difficult. As with this patient, the nature of the lesions was initially unclear due to the various tissues involved. Synaptophysin and chromogranin are specific to neuroendocrine tumors which were found in both the esophagus and trochanter. CK7 and CK20 which are markers usually found in gastrointestinal mucosa, were unusually found in the trochanter. Furthermore, biopsies of the esophagus and stomach were negative for gastric adenocarcinoma. This indicates that these new lesions were not due to a recurrence of the patient’s prior stomach cancer. Although brain and lung biopsies were not conducted due to their invasive nature, the sporadic and isodense appearance of these lesions on radiography suggest that they are likely additional neuroendocrine tumors. Further research is needed to determine if these findings are coincidental or if there is a true association between Barrett’s esophagus and neuroendocrine tumors, as this may allow for prompt diagnosis and treatment.
Figure 1. CT of the head showing an isodense lesion in the cerebellum as marked by the red arrow.
Figure 2. CT of the left trochanter showing an isolated bone lesion as marked by the red arrow.
Figure 3. Biopsy of the esophagus demonstrating a high degree of dysplasia with numerous neuroendocrine cells.
Melanie Burgos indicated no relevant financial relationships.
Jonathan Vincent Reyes indicated no relevant financial relationships.
Fahad Malik indicated no relevant financial relationships.
John Sotiriadis indicated no relevant financial relationships.