MIXED NEUROENDOCRINE-NONNEUROENDOCRINE (MINEN) OF THE ESOPHAGUS: A RARE CASE AND REVIEW OF LITERATURE
James Kurtz, Joseph Lim*, Rene Borscheid, Edward E. Cho, Houssam Osman, D Rohan Jeyarajah
Surgery, Methodist Richardson Medical Center, Richardson, TX
Background: The 2017 World Health Organization (WHO) classification defines Mixed Neuroendocrine-Nonneuroendocrine neoplasms (MiNEN) as neoplasms in which both a neuroendocrine and a nonneuroendocrine component exceeds 30%. This entity was previously known as mixed adenoneuroendocrine carcinoma (MANEC). This is the first reported case that utilized a transhiatal esophagectomy for esophageal MiNEN in the setting of Barrett's esophagus.
Case Presentation: A 67-year-old male presented with gastroesophageal junction high grade neuroendocrine carcinoma in the setting of Barrett's esophagitis with high grade dysplasia. After presentation at a multidisciplinary tumor board, upfront surgery was chosen as the best next step. Transhiatal esophagectomy was performed. Pathology report showed T1bN0M0 invasive mixed adenoneuroendocrine carcinoma arising in setting of Barrett's esophagus.
Conclusions: This very rare case adds to the scant literature on this topic. There is no level one data to suggest how this entity should be managed so we have to rely on case reports, such as this one, to guide our management. 
Barrett's esophagus
A. Adenocarcinoma
B. Neuroendocrine carcinoma
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