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case_images: Upper gastrointestinal endoscopy revealed an esophageal large mass.
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case_images: Upper gastrointestinal endoscopy revealed a large esophageal mass with normal mucosa on the surface at 33 cm distant from an incisor tooth (Fig. 1).
case_images: a) CT scan showed large mass in the lower esophagus. b) PET-CT showed a hypermetabolic esophageal tumor (SUVmax = 7.89).
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case_images: Computed tomography (CT) showed a poorly enhanced large mass in the lower esophagus (Fig. 2a). Positron emission tomography/computed tomography (PET-CT) revealed a hypermetabolic esophageal tumor (standardized uptake value max = 7.89) with no evidence of distant metastasis (Fig. 2b).
case_images: Immunohistochemical findings. Tumor cells were reactive with synaptophysin, chromogranin A stain, and CD56.
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case_images: In addition, synaptophysin, chromogranin A and CD56 were positive (Fig. 3) and the Ki-67 labeling index was 80% by immunohistochemical staining.
case_images: a) CT scan showed metastasis in S6 of the liver. b) PET-CT showed metastasis in the right eighth rib.
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case_images: However, 5 months after the operation, a CT scan showed metastasis in segment 6 of the liver (Fig. 4a). Furthermore, PET-CT showed metastasis in the right eighth rib (Fig. 4b).
case_images: PET-CT showed new metastasis in hilar lymph node and sacrum.
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case_images: The metastasis at the right eighth rib disappeared; however, 2 months after radiation therapy, PET-CT showed a new metastasis of a hilar lymph node in the left lung (Fig. 5a) and sacral bone (Fig. 5b).